Zhovanyk N. Clinical and pathogenetic features of chronic obstructive pulmonary disease with post-tuberculous changes and anemia of chronic diseases

The dissertation is devoted to study features of clinical course, pulmonary function tests, iron metabolism, systemic inflammation markers, microbiological sputum examination, as well as psychoemotional response and quality of life were investigated in patients with chronic obstructive pulmonary disease and post-tuberculous changes or active tuberculosis or without history of tuberculosis with concomitant anemia of chronic diseases or without it. The group of patients with post-tuberculosis changes was characterized by elder age, male predominance, higher frequency of exacerbations, hospitalizations and higher smoking index, as well as more severe clinical course than the group of patients without post-tuberculosis changes. Incidence of anemia was significantly higher among patients with chronic obstructive pulmonary disease and post-tuberculous changes with a predominance of anemia of chronic disease. Among patients with chronic obstructive pulmonary disease and post-tuberculous changes with anemia of chronic diseases vs patients with chronic obstructive pulmonary disease without a history of pulmonary tuberculosis and without anemia of chronic diseases, significantly more pronounced clinical symptoms, bronchial obstruction syndrome,a higher incidence of pulmonary hypertension, stait and trait anxiety and index of depression, systemic inflammation, as well as a higher frequency of pathogenic sputum microflora detection, including a combination of several pathogens, were observed. Prescription of vitamin therapy (group B and C vitamins combination) and amino acid medicine (ademethionine) additionally to standard therapy of chronic obstructive pulmonary disease in patients with post-tuberculous changes and anemia of chronic diseases lead to normalization of clinical course and pulmonary function tests, index of depression as well as red blood and decreased intensity of systemic inflammation.