Aim - study of the influence of komorbidy allergic rhinitis (AR) on the course of bronchial asthma (BA). Materials and methods. Clinical research, single performed by a survey of 96 patients divided into two groups: the main - 73 patients with BA combined with AR and a group of comparison-23 patients who do not have allergic rhinitis. The data of clinic, bronchial passableness, level of control of asthma, severity of inflammation in bronhopulmonary region on content of nitrogen oxide in exhaled air and in nasal flushes of a number of biochemicals were studied in comparative aspect. Indicators, the manifestation of systemic inflammatory response according to biochemical, immunological indicators and calculated lejkocitarnym indices. Results. It is revealed that activity of inflammatory process in patients with BA without AR is higher both in the bronhopulmonary region and at the system level. At the same time in the period of clinical remission, most of them have sufficiently well functioning protective mechanisms on the part of the antioxidant system, humoral immunity, non-specific protection. Conclusion. When combined BA and AR inflammation at both local and system levels is less pronounced, but the activity of protective mechanisms decreases. In parallel to the growth of violations on the part of cell and humoralal links of immunity in the blood increases the content of Circulating immune complexes, which contributes to the torpor current of inflammation, which is the basis of a more significant violation of bronchial permeability and complicates achieve control of asthma. These changes increase as the duration of the disease both BA and AR, as well as frequency exacerbations of the disease.
Background. Assessment of the compensatory capabilities of the body of patients after cardiac surgery at the stationary stage of rehabilitation is of significant scientific and practical interest from the point of view of individualization of rehabilitation therapy for such patients.
Aim. The analysis of clinical and functional status of patients with acute coronary syndrome after percutaneous coronary interventions at the stationary stage of rehabilitation was carried out.
Methods. The algorithm for a comprehensive assessment of health status included general clinical research methods, clinical and somatotypic status; assessment of the degree of stress of adaptive compensatory-adaptive reactions, the state of immunity and physical performance; biochemical research methods in blood serum; six-minute walk test; psychological research methods.
Results. There are revealed signs of violations on the part of carbohydrate, lipid metabolism, antioxidant protection, increase of immune system reactivity, reduction of reserve capabilities of non-specific protective mechanisms, reduction of parameters of full-fledged socio-psychological functioning, which should be taken into account in the preparation of individual rehabilitation programs.
Conclusion. The revealed relationship between integral leukocyte indices and a number of clinical and functional indicators allows us to recommend their use for analyzing the state of adaptive processes in the body and assessing the rehabilitation potential in patients with acute coronary syndrome after cardiac surgery.
Aim. Determination of informativeness of leukocyte indices in patients with bronchial asthma, who have comorbid diseases in clinical remission of asthma.
Materials and methods. The work based on a single examination of 225 patients with bronchial asthma. Criteria for inclusion in the study are following: the presence of a verified diagnosis of bronchial asthma, the phase of clinical remission. The patients have been divided into 4 groups, taking into account the type of comorbid diseases: the 1 group (53 patients) bronchial asthma was combined with lesions of the upper gastrointestinal tract; the 2 group (73 patients) with allergic rhinitis; the 3 group (76 patients) with hypertension; the 4 group (23 patients) comparison group: the patients without comorbid pathology. According to the clinical blood analysis, 10 leukocyte indices were calculated for each group of patients and their values were analyzed taking into account the frequency and severity of deviations from the reference values. Mathematical processing of the material was carried out using the statistical software package SPSS13.0 for Windows.
Results. Using leukocyte indices, it has been revealed that even during the period of clinical remission, almost all examined patients with BA have endogenous intoxication, the severity of which increases in comorbid diseases. Intoxication was inflammatory in nature and, according to the data of leukocyte indices, was due to the presence of persistent inflammation (local and systemic) and during clinical remission. Violation of immunological reactivity has been revealed in most of the examined patients. The presence of correlation relationships of leukocyte indices with a number of biochemical and immunological indicators allows one to exclude the latter from the plan of examination of patients without reducing the quality of their examination: for example, in the conditions of polyclinics, small hospitals, and resorts. Eight leukocyte indices that are the most informative at BA have been selected.
Conclusion. Additional information about the condition of BA patients who have comorbid diseases during clinical remission can be used to develop programs for their comprehensive treatment and rehabilitation.
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