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the MAINTENANCE

The list of reductions......................................................................................................................... 4

Introduction............... 6

Chapter 1. The literature review........................................................................................................

11

1.1. HOBL: risk factors, features of inflammatory process, the reason of an exacerbation 11

1.2. Features of an immunologic inflammation at patients bronyohialnoj an asthma 21

1.3. A combination of chronic obstructive illness of lungs and bronhiyoalnoj asthmas 30

1.4. A role of glucocorticoid hormones at diseases of lungs.......................... 31

1.5. Treatment gljukokortikosteroidnymi preparations............................................... 39

1.6. Use of an estimation of quality of a life (KZH) in medicine.................................... 43

Chapter 2. Materials and methods................................................................................................. 47

2.1. The clinical characteristic of the surveyed patients...................................... 47

2.2. Research methods.................................................................................................... 68

2.2.1. Inspection of function of external breath..................................................... 69

2.2.2. Research diffuzionnoj abilities of lungs....................................... 69

2.2.3. Microcirculation research in lungs....................................................... 70

2.2.4. Hydrocortisone definition in a blood plasma of patients...................................... 70

2.3. Methods of studying of quality of a life............................................................................... 70

2.4 Statistical processing............................................................................................. 71

Chapter 3. Results of own researches................................................................ 72

3.1. Treatment of exacerbation HOBL............................................................................................ 72

3.1.1. An estimation of clinical symptoms at patients HOBL and HOBL in a combination with And 75

3.1.2. An estimation of laboratory indicators at patients HOBL and HOBL

In a combination with BA.................................................................................................................. 86

3.1.3. Change of indicators of function of external breath at a pain - nyh HOBL and HOBL in a combination with BA............................................................................. 90

3.1.4. Change of concentration of a hydrocortisone in blood at patients HOBL

And HOBL in a combination with BA.................................................................................................. 94

3.1.5. By-effects of steroid therapy at patients HOBL and

HOBL in a combination with BA..................................................................................................... 96

FOR.6. Clinical examples.......................................................................................... 96

3.2. Treatment HOBL of a stable current 104

3.2.1. Dynamics laboratory-tool it is indicative at patients HOBL against therapy by broncholitic preparations (group 1) 104

3.2.2. Dynamics of laboratory-tool indicators at patients HOBL against therapy broncholitic and ingaljatsionyonymi gljukokortikostsroidiymi preparations (group 2)............................................. 107

3.2.3. Dynamics of laboratory-tool indicators at patients HOBL in a combination with BA against therapy bronholiticheyoskimi and inhalation gljukokortikosteroidnymi preparations (group 3)............................................. 111

3.2.4. Dynamics of laboratory-tool indicators at patients HOBL in a combination with GZBA against therapy bronholiticheyoskimi and inhalation gljukokortikosteroidnymi preparations (group 4)............................................. 114

3.3. The maintenance of a hydrocortisone and by-effects gljukokortikostsro-idnoj therapies at patients HOBL and HOBL in a combination with BA 117

3.4. Change of quality of a life at patients HOBL and HOBL in a combination sba...... 118

Chapter 4. Discussion of the received results................................................................ 121

Conclusions............ 132

Practical references................................................................................................... 133

The list of the used literature.................................................................................... 135

The list of the printing works published on a theme of the dissertation................................ 162

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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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