Assessment of endogenous intoxication based on the study of medium and low molecular weight substances in patients with myocardial infarction against a background of chronic obstructive pulmonary disease

Abstract

Introduction. Frequent comorbidity of chronic obstructive pulmonary disease and myocardial infarction is due to the commonality of a number of etiopathogenetic links and the development of endogenous intoxication syndrome. The convincing markers of endogenous intoxication syndrome are medium and low molecular weight molecules including medium and low molecular weight substances and oligopeptides.Aim. To study the levels of medium and low molecular weight substances in patients with myocardial infarction against the background of chronic obstructive pulmonary disease.Materials and methods. 225 patients with myocardial infarction were examined. In 195 patients the infarction developed against the background of COPD, in 130 patients – without COPD. The comparison group consisted of 110 somatically healthy individuals. Substances of medium and low molecular weight (MLMWS) and oligopeptides (OP) were determined by direct spectrometry (according to M.Y. Malakhova, 1995) in plasma, erythrocytes and urine. Endogenous intoxication indices and intoxication coefficient were calculated on the basis of these indices. Statistical processing of the data was performed using SPSS 26.0 software package.Results. In blood plasma and erythrocytes, the levels of average molecules in both studied groups were statistically significantly higher compared to controls. The highest levels were detected in comorbid patients. In the group of patients with myocardial infarction without chronic obstructive pulmonary disease 60% of the examined patients had phase I endogenous intoxication. Phase III intoxication prevailed among comorbid patients with myocardial infarction against chronic obstructive pulmonary disease – 62,6%.Conclusions. Molecules of average mass have proven to be informative indices of endogenous intoxication syndrome in patients with myocardial infarction accompanied by chronic obstructive pulmonary disease. This opens the prospect of using these indices in the development of assessment scales and the creation of prognostic algorithms in patients with cardiorespiratory comorbidity.