Abstract
Aim. To study the ventilation function of the lungs in patients with varying degrees of severity of chronic obstructive pulmonary disease (COPD) and in patients with COPD combined with lung cancer (LC), as well as to establish the features of its disorders using spirography and body plethysmography. Materials and methods . A clinical and functional study of 57 individuals was carried out with 10 healthy patients (control group), 30 patients with COPD and 17 patients in whom LC was combined with COPD using the Masterlab Pro diagnostic complex (Erich Jaeger, Germany). Results . In patients with early COPD, a decrease in MEF 75 (a ventilation parameter characterizing small airway patency) is the most informative. With the progression of bronchial obstruction, both restrictive and obstructive disorders, characterized by a decrease in FEV 1 , VC, a change in the structure of the total lung capacity in the form of an increase in the RV/TLC ratio such as an increase in the RV/TLC ratio and an increase in bronchial resistance were recorded. In patients with LC and mild COPD, pulmonary volumes, capacities, flow-volume loop and bronchial resistance parameters did not differ from patients with COPD with a similar bronchial obstruction. In patients with LC and more severe COPD, in contrast to patients suffering from a similar severity of COPD, a decrease in the patency of large, medium and small diameter bronchi (PEF, MEF 25 , MEF 50 , MEF 75 ) was detected, which indicated development of generalized bronchial obstruction. Conclusion . Modern diagnostics of pulmonary ventilation disorders in patients with LC and COPD should be aimed at identifying the disease, and drug therapy should target maximum leveling of reversible components of bronchial obstruction in order to increase the functional reserve of the respiratory system and reduce the risk of postoperative complications caused by COPD.
Highlights
Изменение вентиляционной функции легких в процессе формирования хронической обструктивной болезни легких и при ее сочетании с раком легкого
Изучение вентиляционной функции легких у пациентов с различной степенью тяжести хронической обструктивной болезни легких (ХОБЛ) и при ее сочетании с раком легкого (РЛ), а также установление особенностей респираторных нарушений с помощью спирографии и бодиплетизмографии
To study the ventilation function of the lungs in patients with varying degrees of severity of chronic obstructive pulmonary disease (COPD) and in patients with COPD combined with lung cancer (LC), as well as to establish the features of its disorders using spirography and body plethysmography
Summary
У пациентов, страдающих РЛ в сочетании с нетяжелой ХОБЛ, показатели вентиляции легких и бронхиальное сопротивление не отличались от пациентов с ХОБЛ, имеющих аналогичную степень бронхиальной обструкции. При РЛ в сочетании с более тяжелой ХОБЛ, в отличие от пациентов, страдающих аналогичной тяжестью ХОБЛ, установлено снижение проходимости бронхов крупного, среднего и мелкого диаметра (пиковая объемная скорость, МОС25, МОС50, МОС75), свидетельствующее о развитии генерализованной бронхиальной обструкции. Современная диагностика нарушений вентиляции легких у больных РЛ в сочетании с ХОБЛ должна быть направлена на выявление, а медикаментозная терапия – на максимальное нивелирование обратимых компонентов бронхиальной обструкции с целью повышения функционального резерва системы дыхания и снижения риска послеоперационных осложнений, вызванных ХОБЛ. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи. Добнер С.Ю., Дубаков А.В., Поровский Я.В. и др
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