pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2011-0-2-81-86pulmo-382Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESВЛИЯНИЕ МЕТОДОВ ЛЕГОЧНОЙ РЕАБИЛИТАЦИИ НА МАРКЕРЫ СИСТЕМНОГО ВОСПАЛЕНИЯ И УРОВЕНЬ ТЕСТОСТЕРОНА В КРОВИ У БОЛЬНЫХ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХEFFECTS OF PULMONARY REHABILITATION ON MARKERS OF SYSTEMIC INFLAMMATION AND SERUM TESTOSTERONE LEVEL IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASEМещеряковаН. Н.MeshcheryakovaN. N.

к. м. н., старший научный сотрудник лаборатории реабилитационных программ и состояния здоровья

1050077, Москва, ул. 11-я Парковая, 32, к. 4

тел.: 8-903-744-24-63

к. м. н., старший научный сотрудник лаборатории реабилитационных программ и состояния здоровья

1050077, Москва, ул. 11-я Парковая, 32, к. 4

тел.: 8-903-744-24-63

m_natalia1967@inbox.ruБелевскийА. С.BelevskyA. S.

д. м.н., профессор кафедры пульмонологии 

117997, Москва, ул. Островитянова, 1

тел.: (495) 963-24-67

д. м.н., профессор кафедры пульмонологии

117997, Москва, ул. Островитянова, 1

тел.: (495) 963-24-67

pulmobas@yandex.ruЧернякА. В.ChernyakA. V.

к. м. н., зав. лабораторией функциональных и ультразвуковых методов исследования

1050077, Москва, ул. 11-я Парковая, 32, к. 4

тел.: (495) 465-53-84

к. м. н., зав. лабораторией функциональных и ультразвуковых методов исследования

1050077, Москва, ул. 11-я Парковая, 32, к. 4

тел.: (495) 465-53-84

achi2000@mail.ruЛебединЮ. С.LebedinYu. S.

к. м. н., ведущий научный сотрудник лаборатории патологической анатомии и иммунологии 

1050077, Москва, ул. 11-я Парковая, 32, к. 4

тел.: (495) 510-57-0

к. м. н., ведущий научный сотрудник лаборатории патологической анатомии и иммунологии

1050077, Москва, ул. 11-я Парковая, 32, к. 4

тел.: (495) 510-57-0

ФГУ "НИИ пульмонологии ФМБА России"РоссияФГУ "НИИ пульмонологии ФМБА России"Russian FederationФУВ ГОУ ВПО РГМУ РосздраваРоссияФУВ ГОУ ВПО РГМУ РосздраваRussian Federation201128042011028186Copyright © Мещерякова Н.Н., Белевский А.С., Черняк А.В., Лебедин Ю.С., 20112011Мещерякова Н.Н., Белевский А.С., Черняк А.В., Лебедин Ю.С.Meshcheryakova N.N., Belevsky A.S., Chernyak A.V., Lebedin Y.S.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/382

Резюме. Хроническая обструктивная болезнь легких (ХОБЛ) – заболевание, которое затрагивает не только респираторную систему, но и обладает системными эффектами, включающими в себя поражение периферической мускулатуры, синовиальных оболочек суставов, сосудов, а также депрессивные расстройства. Причиной системных эффектов являются, с одной стороны, последствия болезни на организменном уровне, с другой – прямое воздействие медиаторов системного воспаления. Одной из важнейших составных частей лечения больных ХОБЛ в настоящее время признана легочная реабилитация. В ФГУ "НИИ пульмонологии ФМБА России" было проведено исследование, целью которого была оценка влияния одного из методов легочной реабилитации – физической тренировки – на маркеры системного воспаления и тестостерон у больных ХОБЛ. В исследовании участвовал 31 пациент с ХОБЛ III–IV стадии. 16 пациентам проводилась традиционная медикаментозная терапия согласно тяжести состояния, с использованием методов физической реабилитации,15 пациентам проводилась только медикаментозная терапия. В результате исследования в группе пациентов, получающих физическую реабилитацию, улучшились показатели теста с 6-минутной ходьбой на 80 м, увеличились показатели объема форсированного выдоха за 1-ю с на 13 %, уменьшились показатели функциональной остаточной емкости на 14 % и остаточного объема легких – на 30 %. В группе пациентов, получающих только медикаментозную терапию, данные показатели не изменились или изменились незначительно. Изменение показателей системного воспаления и тестостерона также было достоверным в группе пациентов с физической реабилитацией.

Summary. COPD affects not only the respiratory system but has systemic effects including peripheral muscle dysfunction, synovial and vascular pathology and depression partly caused by the direct influence of inflammatory mediators. Pulmonary rehabilitation is recognized as a crucial component of management of patients with COPD. This study was performed in Research Institute of Pulmonology of Federal Medical and Biological Agency and evaluated one of rehabilitation methods, namely physical training, in term of its influence on systemic inflammation markers and level of testosterone in COPD patients. The study involved 31 patients with COPD stage III–IV treated with standard drug therapy according to the disease severity. Of them, 16 patients were involved in pulmonary rehabilitation programs. As a result, pulmonary rehabilitation group patients improved 6-min distance by 80 m, FEV1 by 13 % and decreased FRV by 14 % and RV by 30 % from baseline. These parameters did not change or changed non-significantly in patients treated with medications alone. Systemic inflammation and testosterone level were also improved in pulmonary rehabilitation group.

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