Chetajkina A. Clinical and pathogenetic features of the gastroduodenal erosive-ulcerous lesions for patients with chronic obstructive pulmonary disease

The dissertation is dedicated to optimization of diagnostics and prognosis of the gastroduodenal erosive-ulcerous lesions course for patients with chronic obstructive pulmonary disease with the aim of choosing the optimal treatment tactics for this comorbidity pathology. The scientific innovation is in the fact of adding the information about the features of the gastroduodenal erosive and ulcerous lesions course for patients with chronic obstructive pulmonary disease by newly received evidence about the most significant risk factors of this comorbidity, aggression and protection of the stomach and duodenum, as well as the interaction of tumor necrosis factor and prostaglandin E2, what promotes the possibility to clarify the mechanisms of these violations and establishes the relationships between their individual indicators. The diagnostic significance of the TNF-α and PGE2 determination in patients with COPD in combination with erosive-ulcerative lesions of the gastroduodenal zone was distinguished, which makes the opportunity to estimate the levels of proinflammatory and protective cytokines for further treatment correction. It has been investigated that the inclusion of rabeprazole and rebamipide for the treatment of gastroduodenal erosive-ulcerative lesions for patients with COPD in combination with basic therapy of the main disease has a positive clinical effect, which is confirmed by a decreasing of gastroduodenal pathology clinical manifestation, erosive-ulcer defects healing according the FGDS result and changes in TNF-α and PGE2 range. The practical value of the results are based on the recommendation of additional criteria for the erosive-ulcerative lesions diagnostics for patients with COPD, consisting of the comprehensive assessment of risk factors, clinical manifestations, spirometry data, FGDS, factors of acid-peptic aggression and protection and measurment the TNF- α and PGE2 level for appropriate correction of the therapy.