Özet:

The aim of the study was the revelation of the comorbidity influence in patients with the combined pathology of bronchial asthma and chronic obstructive pulmonary disease on clinical manifestations and symptoms of the disease, system inflammation factors and breath functional parameters. Materials and methods. The study included 140 patients with the combined bronchial obstructive pathology of the mean age 58,56±0,81 years, 74 women, 66 men. All patients underwent the spirometry and bodypletizmography (“Master Screen PFT”, Germany). The test with 6-minutes walking was realized according to the standard protocol. The determination of the clinical course severity and disease prognosis was assessed by BODE index. All patients underwent the clinical analysis of blood, coagulogram, determination of highly-specific C-reactive protein. The level of dyspnea was assessed in all patients by the modified scale of the medical research council (mMRC), and also the index of basic dyspnea (BDI). The general point by the Charlson comorbidity index was calculated for all patients. Results. With the increase of the number of concomitant diseases, the intensity of symptoms and functional disorders, inherent to bronchial asthma and chronic obstructive pulmonary disease increased. At the high level of comorbidity index, dyspnea was reliably more essential (by mMRC) comparing with one of patients with the low and middle level of comorbidity (p<0,05); functional disorders were more intense, realization of a usual activity was complicated (by BDI). Patients with the combined bronchial obstructive pathology with the high comorbidity level had the decreased physical tolerance (in the test with 6-minutes walking) and also reliably worse disease prognosis (higher BODE-index). The increase of comorbidity index was attended by negative changes of volumes, capacities, parameters of bronchial permeability at all levels of respiratory tracts in patients with the combined bronchial obstructive pathology. Patients with the combined pathology with the high comorbidity index had reliably higher indicators of the system inflammation (С-reactive protein, fibrinogen) comparing with patients with the middle and low comorbidity indices (р<0,05). Patients with the middle comorbidity level had the reliably higher content of neutrophils of peripheral blood comparing with one of patients with the low comorbidity (р<0,05).Conclusions. Patients with the combined brionchial obstructive pathology at additional comorbid diseases demonstrated the essential intensification of clinical manifestations and symptoms of the disease, worsening of external breath function indices, intensification of the system inflammation and prognosis worsening. The combination of diseases played also rather important role at the combined bronchial obstructive pathology Author Biography Ksenia Nazarenko, SO “National institute of phthisiology and pulmonology named after F. G. Yanovskyi NAMSof Ukraine” M. Amosova str., 10, Kyiv, Ukraine, 03141 PhD Department of Pulmonology 

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