The thesis research is devoted to the improvement of treatment effectiveness of COPD patients with III degree of bronchial obstruction and overweight by studying the peculiarities of its course and the use of xanthine as part of the complex therapy, as well as lifestyle modification. The study involved 135 individuals. The first stage involved the study of the peculiarities of COPD course (III degree of bronchial obstruction), depending on the BMI and the phase of pathology. For this reason, the following groups of patients were identified: main study group consisted of 45 patients suffering from COPD (III degree of bronchial obstruction) with overweight; the average age was (61.6 ± 3.1) years. The comparison group involved 67 patients with COPD (III degree of bronchial obstruction) with normal body weight; the average age was (62.9 ± 2.8) years. Patients were observed in the stable phase of the pathological process and in the exacerbation phase. The control group consisted of 23 apparently healthy individuals without any signs of pulmonary diseases or any other pathologies of internal organs, representative by sex and age, while 12 of them were overweight. The study revealed that COPD (III degree of bronchial obstruction) is accompanied by increased shortness of breath, impaired respiratory function, intensified cough, severe manifestations of systemic inflammation in the body, evidenced by increased levels of leptin, CRP, TNF-α and sICAM-1 and changes in the quality of life. The second stage involved the study of the effectiveness of worked-out complex therapy for COPD (III degree of bronchial obstruction) patients with overweight. The research findings proved that the treatment of overweight patients who suffer from COPD (III degree of bronchial obstruction) with xanthine as part of their complex therapy and lifestyle modifications contributes to a more significant improvement in clinical and functional indices, namely reduces shortness of breath, cough, moist rales, wheezing, improves respiratory function, shows positive dynamics of inflammatory response, resulting in better quality of patient’s life. The study made it possible to supplement the scientific concept of determining the factors for predicting the course and progression of COPD (III degree of bronchial obstruction) by studying the role of systemic inflammation in patients with overweight. The scientific data suggest that increased systemic inflammation, which is characteristic of COPD (III degree of bronchial obstruction), is observed in overweight patients, accompanied by a significant increase in levels of TNF-α, CRP, leptin and sICAM-1 in blood serum. Based on the studied factors it became possible to establish the role of excessive body weight in rapid progression of COPD (III degree of bronchial obstruction). We have evidenced the advantages of xanthine use in complex treatment and lifestyle modification in compliance with the standards of basic therapy and analyzed the effectiveness of the suggested treatment approach in the improvement of clinical course of this comorbid condition, suppression of inflammatory activity and improvement of the quality of patient’s life. The research findings revealed that COPD (III degree of bronchial obstruction) in overweight patients is accompanied by changes in the inflammatory response, accompanied by increased serum levels of CRP, TNF-α, leptin and sICAM-1. The study proved the importance of determining the levels of these indicators in peripheral blood serum in order to assess the activity of inflammatory process and take measures to prevent the progression of COPD (III degree of bronchial obstruction) in patients with overweight. We have substantiated the use of xanthine medication as a part of complex therapy of COPD (III degree of bronchial obstruction) exacerbations in patients with overweight with subsequent recommendations on lifestyle modifications, which showed positive influence on the course of the disease and quality of patient’s life. We have rationalized the necessity to assess the QOL (respiratory questionnaire of St. George’s Clinic, SGRQ) to identify the impact of the disease on the patient’s physical and psychological state. We have set forward the method for predicting the development of exacerbations in patients suffering from chronic obstructive pulmonary disease (III degree of bronchial obstruction) with overweight by determining the levels of CRP and leptin in blood serum. Key words: chronic obstructive pulmonary disease, bronchial obstruction, overweight, systemic inflammation, treatment. Branch – medicine.
