Karasiova O. Clinical, functional indicators and markers of systemic inflammation in the assessment of pulmonary fibrosis formation

The thesis research presents data collected through studying pathological processes that determine the development and course of idiopathic pulmonary fibrosis (IPF) and systemic scleroderma (SSD) complicated by pulmonary fibrosis development, as well as improved diagnostic standards taking into account the severity of the process. The analysis of the archived patient records for the period of 2009 - 2019 has been carried out, 34 patients with IPF (Group 1) and 28 patients with SSD complicated by pneumofibrosis (Group 2) have been selected for further examination. Using mMRC dyspnea scale, VAS scale (visual-analog scale) and Wood-Down’s modified scale, the disease severity has been determined, thus allowing to divide the groups of patients into subgroups – moderate and severe. The comparison group consisted of 11 people compatible in age and sex and having no signs of pulmonary fibrosis. The examination of patients has been carried out in compliance with the unified program including clinical analysis of data, high-resolution computer tomography, laboratory-diagnostic and instrumental methods. As additional prognostic markers of the clinical course severity, acute phase indicators of systemic inflammation have been studied, the level of activity of MMP -2 and -9 and their complexes, blood serum TPA have been identified. The results of the study have been processed using a set of statistical methods. The obtained results have become the basis for selection of clinically significant indicators of diagnostics and determination of their prognostic potential for assessment of the risk of severe course of disease. Scientific data on determination of biochemical laboratory parameters and markers of systemic inflammation in patients with IPF and SSD complicated by pneumofibrosis have been supplemented. The criteria that are the basis for determining the severity of IPF and SSD complicated by pneumofibrosis have been specified. For the first time ever, it has been proposed to monitor the severity of IPF and SSD complicated by pneumofibrosis development by using mMRC dyspnea scale, VAS scale and Wood-Down’s modified scale, taking into account biochemical parameters. The obtained results of assessing the course of IPF have been summarized in form of a utility model patent and provide opportunities to optimize the management of patients with IPF by assigning appropriate treatment.