Gashynova K. Chronic obstructive pulmonary disease: prognosis and treatment optimization in accordance with local lesion and systemic manifestations

Object of research - chronic obstructive pulmonary disease; the aim: development of diagnostic and treatment tactics for chronic obstructive pulmonary disease (COPD) by constructing the models of exacerbation and hospitalization risks prediction, taking into account the severity of the local lesion and COPD systemic manifestations in stable patients and during acute exacerbations; methods: general clinical, anamnestic and laboratory investigation; anthropometric (height and weight measurement, bioelectric impedance investigation); instrumental (spirography, X-ray, electrocardiography, occlusion pneumotonometry, pulseoximetry); questionnaire; 6-minute walk test; blood alfa-1-antitrypsin and surfactant protein D and fraction of nitric oxide in exhaled air measurements; statistical analysis; novelty: a combination of local leisure markers, signs of systemic manifestations, respiratory failure and comorbid conditions which increased the risk of disease exacerbation was established for the first time in stable out-patients with COPD; for the first time nutritional status characteristics, anamnestic factors, signs of systemic inflammation and respiratory failure were defined to determine the risk of re-hospitalization due to COPD exacerbation in patients with severe COPD exacerbation; for the first time expediency of alfa-1-antitrypsin and surfactant protein D in blood and fraction of nitric oxide in expelled air measurements were substantiated and proved for the COPD diagnostics improvement; the additional indications for the inhaled glucocorticosteroids/long acting, beta2-agonists combination in a single inhaler were determined in stable COPD patients with signs of respiratory muscles fatigue or elevated blood surfactant protein D. The field of application is medicine.