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3.2.3. Dynamics of laboratory-tool indicators at patients HOBL in a combination with BA against therapy broncholitic and inhalation gljukokortnkosteroidnymn preparations (group 3)

32 patients HOBL have been included in the third group in a combination with BA which against atroveita 160мкг a day and beroteka 400мкг a day, within 6 months accepted inhalation gljukokortikosteroidnye hormones.

In recalculation on beklomsgazon the average dose has made Dipropionas 943,33±92,95мкг a day.

Have agreed on repeated hospitalisation only 24 of 32 (75,00 %) patients; 8 of 32 (25,00 %) have refused repeated inspection on personal circumstances.

Against long reception IGKS of hormones at patients HOBL in a combination with BL it is authentic (r-0,03) the maintenance of eosinocytes, macrophages in a sputum (tab. 52) has decreased. Concentration of neutrophils, lymphocytes, monocytes remained at former level. Similar pattern remained both at patients with moderate severity level HOBL, and with a serious current of disease.

Table 52

Indicators of the cytologic research of a sputum at patients HOBL in a combination with BL against therapy IGKS by hormones (Myot)

1 Index (%) Before treatment п=24 After treatment gg-24
nejtrofnly sputums 35,32±2,70 40,5513.31
Sputum eosinocytes 18,68±2,38 12,18=1.35*
Sputum macrophages 21,3911,97 15,9112,22 * ♦
Sputum lymphocytes 9,14±0,47 9,2710,70
Sputum monocytes 6,1110,82 6,7311,10

*-р 0,03; **-r-0,008

The carried out research has shown, that against treatment indicators of function of external breath and gas structure of blood at patients HOBL in a combination with BA tended to improvement (tab. 53). Authentically (р=0,03) it was enlarged ОФВ1 (64,0612,09 %) in comparison with reference values (54,81±2,55 and 66,1112,55 %). The expressed bronchospasm (gain ОФВ1 of 26,83*3,48 %) was initially defined, against therapy IGKS by preparations the bronchospasm has considerably decreased and began to correspond moderated (gain ОФВ1 of 18,8915,62 %).

Indicators of function of external breath and gas structure of blood at patients HOBL in a combination with L against therapy IGKS by hormones (Myot)

Indicator, (% from due size) Initially p - 24 6 months p = 24
ОФВ1 54,81 ±2,55 64,06*2,09 *
ZHEL

72,91*2,57 81,14*4,66
TIFFNO 61,93*2,43 63,94*4,13
ОФВ1 After beroteka 66,11*2,55 75,92*5,04
ZHEL after beroteka 86,40*2,73 94,29*5,12
TIFFNO after beroteka 66,50*2,42 68,45*3,46
Convertibility of obstruction 26,83*3,48 18,89*5,62
Ra 02 (mm.rt.st.) 72,19*1,57 77,42*2,88
1 РаС02 (mm.rt.st.) 38,25*0,65 37,84*1,92

* - р=0,03

At patients HOBL in a combination with BA against therapy IGKS by preparations the tendency to normalisation diffuzionnoj abilities of an alveolar membrane became perceptible; blood volume in pulmonary capillaries; effective alveolar volume (tab. 54).

Table 54

Research diffuzionnoj abilities of lungs at patients HOBL p a combination with BA against therapy IGKS by hormones (Myot)

Indicator (% of due size) Before treatment п=12 After treatment p = »12
DL (> 81) 62,35*3,94 66,93*5,94
KSO (> 80) 81,25*4,61 80,83*8,59
Dm (> 75) 57,75*3,35 62,00±8,86
Vc (> 80) 76,50*7,79 83,33*16,17
Va eir.

1

76,00*4,01 82,60*9,22

0,05

As it is presented in table 55, at patients HOBL in a combination with BA against therapy IGKS by preparations total accumulation RFP in the right lung was a little above normal value (norm 51,9-54,3; after treatment 56,0510,97). However in comparison with normal value


Distribution RFP in departments of the right lung was within normal value. While, total accumulation RFP in the left lung was more low in comparison with normal value (norm 46-47,8; after treatment 43,9510,97) at what basically the given depression was at the expense of reduction mikrotsnrkuljatsii in the bottom share (norm 15,22-17,98; after treatment 13,1511,11). Besides it at 100 % of patients after treatment local defects of accumulation tehnetsija have been taped.

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Scientific source Yefimova Olga Aleksandrovna. ESTIMATION of EFFICIENCY of TREATMENT GLJUKOKORTIKOSTEROIDNYMI PREPARATIONS of LUNGS SICK of CHRONIC OBSTRUCTIVE ILLNESS. The DISSERTATION on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg - 2007. 2007

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