The new coronavirus infection COVID-19, due to the complex pathogenesis of the disease, systemic impact on organs, the development of complications and persistent disorders after the infection, remains an important medical problem. Every year the number of patients with postcovid syndrome in need of timely and full rehabilitation is increasing. Recently, isolated work began to appear on the use of interval hypoxytherapy for the treatment of patients with coronavirus infection. The purpose of our study was to identify the long-term results of the effect of interval hypoxytherapy on the immunological and coagulation status of patients after suffering coronavirus infection COVID-19. 170 patients aged 45 to 59 years were examined after a moderate coronavirus infection before, after and three months after interval hypoxytherapy. The number of lymphocytes, immunoglobulins A, M, G, E and cytokines (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, TNFα) in blood, blood D-dimer, prothrombin time, fibrinogen in blood, antithrombin III, C-reactive was determined protein and ferritin in the blood. The conducted studies revealed changes in immunological reactivity after the coronavirus infection COVID-19, requiring correction. Interval hypoxytherapy had an immunomodulatory effect and led to the normalization of the main immunological parameters, which remained three months after hypoxytherapy: there was a significant (p < 0.05) increase in the number of CD3+T lymphocytes, CD4+T lymphocytes, CD8+T lymphocytes. The improvement in immune status was also evidenced by the normalization of the immunoregulatory index, an increase in the level of immunoglobulins A and G. The decrease in immunoglobulins E in the blood was an indicator of a decrease in the severity of sensitization of the body. The course of hypoxytherapy led to a decrease in the content of pro-inflammatory cytokines: IL-1β, IL-2, IL-6, IL-8, TNFα and an increase in anti-inflammatory cytokines: IL-4 and IL-10 in the blood, which indicated an attenuation of the inflammatory process in the lung tissue and in the body as a whole. Blood ferritin decreased 3 months after hypoxytherapy. As studies have shown, the effect of hypoxytherapy persists for three months after the course of treatment. Thus, interval hypoxytherapy can be recommended for the rehabilitation of patients after a moderate coronavirus infection. A repeated course of hypoxytherapy may be performed three months after the first course of hypoxytherapy.
The purpose of the paper is to identify the efficacy of normobaric interval hypoxic therapy in the treatment and rehabilitation of bronchial asthma patients, taking into account their individual characteristics of circadian rhythms. Materials and Methods. The authors examined the indicators of the functional respiratory system and oxygen regimes of the body, lipid peroxidation and antioxidant system and spirometric data in 145 patients with bronchial asthma. Patients’ chronotypes were also determined. Bronchodilators were used to carry out individual peak flowmetry and to determine airway sensitivity, which made it possible to reveal the bronchial tree reactivity. In order to identify individual intolerance to the hypoxic factor and to select the optimal oxygen level in the gas mixture all patients underwent a hypoxic test before the hypoxic therapy. Results. The results obtained showed that morning hypoxic therapy sessions had the greatest effect in patients with bronchial asthma. A decrease in the malondialdehyde level indicated a decrease in lipid and protein peroxidation. An increase in the blood glutathione peroxidase and superoxide dismutase rates showed an increase in antioxidant protection. Intermittent normobaric hypoxic therapy improved the body oxygen supply during its transport and contributed to oxygen intake and a hypoxic decrease in the bronchopulmonary system. The hypoxic mixture was chosen individually, taking into account patient’s chronotype, in order to induce the subcompensated hypoxia. However, the morning hours turned out to be optimal for the greatest mobilization of compensatory mechanisms and adaptation to hypoxia in most patients. Conclusion. We consider it necessary to adjust recommendations for the use of intermittent normobaric hypoxic therapy in bronchial asthma patients, taking into account their circadian rhythms, and to recommend conducting hypoxic therapy in the morning and in the afternoon (from 8 a.m. to 3 p.m.). Keywords: bronchial asthma, intermittent hypoxytherapy, chronotypes, functional respiratory system, prooxidant and antioxidant systems. Цель – определение эффективности использования нормобарической интервальной гипокситерапии в лечении и реабилитации пациентов с бронхиальной астмой с учетом индивидуальных особенностей суточных ритмов. Материалы и методы. У 145 пациентов с бронхиальной астмой анализировались показатели функциональной системы дыхания и кислородных режимов организма, перекисного окисления липидов и антиоксидантной системы, спирометрические данные; определялись хронотипы больных. С помощью пробы с бронходилятатором проводилась индивидуальная пикфлоуметрия и определялась чувствительность дыхательных путей, что позволило выявить степень реактивности бронхиального дерева. Перед гипокситерапией всем больным проводился гипоксический тест с целью выявления индивидуальной непереносимости гипоксического фактора и подбора оптимального содержания кислорода в газовой смеси. Результаты. Полученные результаты показали, что наибольшим эффектом обладают утренние сеансы гипокситерапии. Понижение уровня малонового диальдегида явилось показателем снижения перекисного окисления липидов и белков. Рост уровня глютатионпероксидазы и супероксиддисмутазы в крови свидетельствовал об усилении антиоксидантной защиты. Интервальная нормобарическая гипокситерапия улучшила обеспечение организма кислородом на этапах его транспортировки и способствовала повышению потребления кислорода тканями, а также снижению степени гипоксии в бронхолегочной системе. Несмотря на то, что гипоксическая смесь подбиралась пациентам индивидуально с учетом их хронотипов и с целью вызвать развитие субкомпенсированной гипоксии, оптимальными для наибольшей мобилизации компенсаторных механизмов и адаптации к гипоксии оказались утренние часы. Выводы. Считаем необходимым внести коррективы в рекомендации по использованию интервальной нормобарической гипокситерапии у пациентов с бронхиальной астмой с учетом суточных ритмов и рекомендовать проведение курсов гипокситерапии в утренние и дневные часы – в промежутке с 8 до 15 ч. Ключевые слова: бронхиальная астма, интервальная гипокситерапия, хронотипы, функциональная система дыхания, прооксидантная и антиоксидантная системы.
Brain bioelectrical activity and the degree of cerebral blood supply directly determine physiological brain activity. There is insufficient evidence on the regularity and continuity of these processes. The aim of the study is to conduct a comparative analysis of brain bioelectrical activity and circulatory supply in adolescents with acute hypoxia. Materials and Methods. The authors examined 100 adolescent males of two age groups: Group 1 consisted of boys aged 12–14 years old, Group 2 included those aged 15–17. Results. The authors revealed a positive correlation between blood supply, metabolism and brain function. In early pubertal adolescents, puberty-associated endocrine changes have a significant effect on EEG and REG indices in adolescents with hypoxia. An increase in the rheographic index is accompanied by an increase in the alpha- and a decrease in the delta-rhythm indices. In pubertal adolescents, an increase in the rheographic index causes a decrease in alpha rhythm and an increase in slow-wave delta oscillations in the frontal and occipital leads. Under short-term hypoxia, an increase in the brain filling with blood is observed. Under oxygen depletion (14%), despite the increase in pulmonary and blood minute volumes, tissue hypoxia develops in pubertal adolescents. It is especially evident in the early puberty, as there is even a decrease in oxygen consumption in adolescents aged 12–14. In adolescents with hypoxia cerebral blood flow increases.
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