ВЫБОР ФУНКЦИОНАЛЬНЫХ МЕТОДОВ ИССЛЕДОВАНИЯ ОРГАНОВ ДЫХАНИЯ В ОЦЕНКЕ РИСКА ВОЗДЕЙСТВИЯ ГОРОДСКОЙ СРЕДЫ НА ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ

Abstract

The aim was to identify the sensitivity of functional methods for studying of respiratory organs in patients with chronic obstructive pulmonary disease (COPD) to a pathogenic environmental impact. There was studied the state of lung function (spirography, bodyplethysmography, pulse oximetry, determination of CO in exhaled air) in 66 patients living in different environmental conditions in Vladivostok and having COPD of different severity. The environmental quality was assessed by the level of air pollution caused by gas components and suspended particulate matter. The meteorological dependence was determined by meteorological parameters on the day of patient’s examination, 1-2 days before and after it. The respiratory system's response to the change in environmental quality was identified using a statistical model that allows predicting the values of the dependent variable Yi (respiratory function) under the impact of the independent variable Xi (environmental factor). It was found out that in mild COPD the methods "determination of CO in exhaled air" and "bodyplethysmography" are the most sensitive to the climatic impact. As the disease progresses, the compensatory mechanisms of respiratory system to climatic effects are violated, while the response of technogenic factors to the pathogenic action increases. The "determining CO in exhaled air" method is the most sensitive to the man-made pollution. Bodyplethysmography allows revealing the formation of "air trapping" and signs of hyperinflation under the influence of unfavorable environmental factors in COPD patients at early stages of the disease. The recommended set of methods makes it possible to assess the risk of COPD progression under the exposure to unfavorable climatic and technogenic factors.