Tiahla O. The state of thiol-disulfide balance and apoptosis activity in patients with a combined chronic obstructive pulmonary disease of II-III stage and essential hypertension II stage in the dynamics of treatment

The dissertation is devoted to the optimization of diagnosis, prognosis and treatment of chronic obstructive pulmonary disease (COPD) stage II-III in combination with essential hypertension (EH) stage II. The presence of a relationship between thiol-disulfide balance disturbance, activation of the apoptosis process and clinical features of patients with COPD and EH was revealed. The prognostic value of the level of caspase-7 above 0.4 ng/ml was established as a high risk for the development of exacerbations and hospitalizations of patients with COPD with EH. It has been proven that an increase in the ST2 protein level of more than 30 ng/ml in patients with COPD with EH is associated with a decrease in FEV1, the presence of left ventricular hypertrophy and impaired sympatho-vagal balance. It was shown that the elevation of the total score of the CAT questionnaire is determined by the presence of changes in thiol-disulfide balance, glutathione metabolism, activation of apoptotic processes, impaired expression of the ST2 protein and changes in cardiac autonomic supply. A model that allows us to determine the individual probability of a violation of the quality of life of patients with COPD and EH has been developed. It was found that basic therapy with the inclusion of L-arginine promotes the regression of clinical symptoms, an improvement in the thiol-disulfide balance and a decrease at the intensification of apoptosis processes.