pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2014-0-2-55-59pulmo-240Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESПРЕДИКТОРЫ ТЯЖЕЛОЙ ОДЫШКИ У БОЛЬНЫХ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ СРЕДНЕЙ СТЕПЕНИ ТЯЖЕСТИPREDICTORS OF SEVERE DYSPNEA IN PATIENTS WITH MODERATE-TO-SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASEТрофименкоИ. Н.TrofimenkoI. N.

к. м. н., доцент кафедры клинической аллергологии и пульмонологии ГБОУ ДПО "Иркутская государственная медицинская академия последипломного образования"; тел.: (9148) 77-80-96

tin11@mail.ruЧернякБ. А.ChernyakB. A.

д. м. н., профессор, зав. кафедрой клинической аллергологии и пульмонологии ГБОУ ДПО "Иркутская государственная медицинская академия последипломного образования"; тел.: (9025) 68-78-70

ba.chernyak@gmail.comГБОУ ДПО "Иркутская государственная медицинская академия последипломного образования" Минздрава России: 664079, Иркутск, мкрн Юбилейный, 100Russian Federation201428042014025559Copyright © Трофименко И.Н., Черняк Б.А., 20142014Трофименко И.Н., Черняк Б.А.Trofimenko I.N., Chernyak B.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/240

Проанализированы клинические данные, показатели спирометрии, бодиплетизмографии, бронхиальной гиперреактивности (БГР) при помощи теста с метахолином, концентрация в крови интерлейкинов (IL) 6 и IL-8 у больных (n = 88) среднетяжелой ХОБЛ (GOLD II) в возрасте 41–79 лет с целью определения ранних предикторов неблагоприятного течения ХОБЛ. По выраженности одышки, оцениваемой по шкале MRC, пациенты стратифицированы на 2 группы: 1-я группа (n = 48) – 0–1 балла, 2-я группа (n = 40) – 3 балла. Для выявления факторов, определяющих различия степени одышки, использовался дискриминантный анализ. Наиболее значимыми детерминантами тяжелой одышки у больных ХОБЛ независимо от объема форсированного выдоха за 1-ю секунду являются длительность заболевания (p < 0,001) и частота обострений (p < 0,001), БГР (p < 0,001), легочная гиперинфляция (p = 0,006), возраст больных (p = 0,023).

The aim of this study was to determine early predictors of COPD course.Methods. In 88 COPD patients (GOLD II) aged 41–79 years, clinical data, spirometry, body plethysmography, bronchial hyperresponsiveness (BHR) in methacholine challenge test, and blood concentrations of IL-6 and IL-8 were analyzed. The patients were divided into two groups according to dyspnea severity: the 1st group (MRC 0–2) included 48 patients, the 2nd group (MRC 3) included 40 patients. Determinants of different severity of dyspnea were identified using the discriminant analysis.Results. FEV1 values were similar in both groups. The most important determinants of severe dyspnea in COPD patients were duration of the disease (p < 0.001), frequency of exacerbations (p < 0.001), BHR (p < 0.001), lung hyperinflation (p = 0.006), and the patient's age (p = 0.023).

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The authors declare that there are no conflicts of interest present.