the MAINTENANCE
The list of reductions......................................................................................................................... 4
Introduction............... 6
Chapter 1. The literature review........................................................................................................
111.1. 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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