The dissertation is devoted to the decision of problems of optimization of diagnostics and treatment of gastroesophageal reflux disease in combination with bronchial asthma by analising changes of the content of galectin – 3 , intereleukins – 4 and – 6 and quality of life of young age patients. The document presents the results of the study - the dynamics of changes in the content of galectin – 3 , intereleukin – 4 and – 6 and the quality of life of young patients with gastroesophageal reflux disease in combination with bronchial asthma.
Problems of diagnostic and treatment of gastroesophageal reflux disease (GERD) are very relevant today, as statistics show that there is a tendency to a significant increase in the incidence of GERD, in particular, among young people. Particular importance is the fact, that among people of this age group is growing the number of patients with GERD and concomitant bronchial asthma. It should be noted that the similar clinical picture and insufficient diagnosis of these conditions leads to errors in the prescribed treatment, which can worsen the condition of patients and lead to further complications, such as changes in the severity of diseases and possible disability of the working population, especially given the long time intervals between the manifestations of the first symptoms of the disease and requesting of the patients to medical institutions, that unfortunately, is a sad reality among the population of Ukraine. The likelihood of such a development necessitates a more in – depth and comprehensive study of this issue.
The study of new biomarkers, which not only increase in the pathological process, but also directly participate in the pathogenesis of GERD and bronchial asthma, is becoming widespread. One of such markers are galectin – 3 , inter-leukins – 4 and – 6 . The aim of the study is to optimize the diagnostics and treatment of young patients with both isolated GERD and concomitant asthma. To achieve this goal, clinical research methods were used, including a survey of patients (identification of complaints and anamnestic data), a comprehensive clinical examination of 108 patients. To address the issues among the examined patients with GERD, depending on the presence of concomitant bronchial asthma, 2 groups of patients were formed. The first group included 38 patients with non-erosive gastroesophageal reflux disease - 27 men (71%) and 11 women (29%) aged 18 to 30 years (mean age 22.2 ± 2.8 years). The second group included 70 patients (49 men - 70% and 21 women - 30%) aged 18 to 30 years (mean age 22.4 ± 2.4 years) suffering from gastroesophageal reflux disease with concomitant, or moderate bronchial asthma. History of asthma ranged from 1 to 2 years. The control group was consisted of 20 healthy individuals (16 men - 80% and 4 women - 20%) aged 20 to 45 years (average age 32.2±2,2 years). So it shows, that the sex and age of the study groups were homogeneous with patients who were included in the groups of patients with GERD without combined pathology and with concomitant from mild to moderate asthma. The diagnosis of GERD was based on the characteristic data of anamnestic, clinical, laboratory and instrumental methods. The diagnosis was established according to ICD-10, relying on the order of the Ministry of Health of Ukraine dated 31.10.2013 № 943, the recommendations of the Montreal World Consensus 2006, the results of EGDS, ultrasound of the esophagus, pH-metry and the questionnaire developed by the L.T.Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine. Verification of the diagnosis of asthma was carried out in accordance with the recommendations of the WHO (GINA) and the order of the Ministry of Health of Ukraine dated October 8, 2013 № 868, relying on the results of spirography and radiography of the chest. Patients' quality of life (QoL) was assessed using the SF-36 Unified Questionnaire, which included assessment of physical health scales (role physical function - PR, physical function - PF, pain intensity - BP and general health - GH) and mental health scales emotional functioning (RE), vitality (VT), social functioning (SF) and mental health (MH)). The level of galectin – 3 in the blood was determined by enzyme-linked immunosorbent assay using a set of reagents "Human Galectin – 3 Platinum ELISA" manufactured by Biosciencse (Austria). Determination of the level of interleukins (IL – 4 and IL – 6) in blood serum was performed by enzyme-linked immunosorbent assay using Vector Best systems.
