Stupnytska A. Chronic obstructive pulmonary disease and obesity: molecular genetic and clinical-pathogenetic features combined course, optimize diagnosis and treatment

The thesis work presents a new approach to the diagnosis and differentiated treatment of patients with chronic obstructive pulmonary disease (COPD), combined with obesity, based on new scientific data on molecular genetic and clinical-pathogenetic features of the comorbid disorders. The bioelectrical impedance analysis, respiratory function tests, exercise tolerance, oxidative stress-proteinase inhibitory imbalances, systemic inflammation, functional state of the endothelium, hemocoagulation, fibrinolysis and morphological and functional properties of erythrocytes in chronic obstructive pulmonary disease based on body mass index has been estimated. The frequency of genotypes for polymorphic variants A46G (rs1042713) and C79G (rs1072714) gene ADRB2, polymorphic variant C646G (rs41423247) gene NR3C1, polymorphic variant S3435T gene MDR1 (rs1045642) in patients with COPD and in the control group has been analysed. The efficiency of improved methods nebulizer therapy, of the drug use (zinc, telmisartan and amlodipine combination of atorvastatin) and effectiveness of pulmonary rehabilitation in patients with COPD combined with obesity has been estimated. The possibility of using of personalized combination therapy with inhaled corticosteroids and beta2-agonists in patients with COPD has been determined.