ПОРІВНЯЛЬНА ОЦІНКА КЛІНІКО-ФУНКЦІОНАЛЬНОГО СТАНУ ХВОРИХ НА ХРОНІЧНЕ ОБСТРУКТИВНЕ ЗАХВОРЮВАННЯ ЛЕГЕНЬ ТА СУПУТНЮ ІШЕМІЧНУ ХВОРОБУ СЕРЦЯ В ЗАЛЕЖНОСТІ ВІД ТЯЖКОСТІ СИНДРОМУ ОБСТРУКТИВНОГО АПНОЕ СНУ ТА БАЗИСНОЇ БРОНХОЛІТИЧНОЇ ТЕРАПІЇ
Journal Title: World Science - Year 2017, Vol 5, Issue 5
Abstract
The aim of the study is to assess the severity of the sleep obstructive apnea / hypopnea syndrome (SOAS) and clinical and functional indices in patients with chronic obstructive pulmonary disease (COPD) and concomitant ischemic heart disease (CHD) on the background of various bronchodilator therapy regimens. 66 patients of this comorbital pathology were examined. Depending on the choice of baseline bronchodilator, all patients were divided into two groups. In order to assess the effect of OSAGS on the course of COPD and CHD diseases, each of the groups was divided according to the severity of apnea (ANI). The diagnostic algorithm consisted of a general clinical examination, spirometry, a 6-minute walk test, measurement of oxygen saturation before and after the distance, evaluation of the results of the Borg and the mMRC questionnaires. To detect violations of breathing during sleep, a screening cardio-respiratory system was used - SOMNOcheck micro. On the background of bronchodilator treatment (according to GOLD criteria) for 12 months, it was found that in patients the clinico-functional indices are significantly lower in the presence of SOAS of moderate and severe degree. In patients taking long-acting M-holinolitics, the number of exacerbations in the dynamics of treatment tended to decrease. The degree of bronchial obstruction, regardless of the degree of severity of the SOAS, did not change comparing to the FEV1 index, in contrast to patients from the β2 agonist group. On the backdrop of treatment with M-cholinolitic, a positive effect of the parameters of the OSAG was registered, more precisely, a decrease in the wake-up index due to respiratory events and an increase in the minimum oxygen saturation during sleep. Thus, the severity of the sleep apnea / hypopnea syndrome correlates with the clinical course of COPD and CHD, so the greater the apnea-hypopnea sleep index is, the worse the clinical and functional indices are. It was noted that in the group that took beta-2-agonists this negative effect was more pronounced than in the group treated with M-holinolitics. The appointment of long-acting M-cholinolitics as a basic therapy for COPD is advisable in patients with concomitant IHD and the presence of obstructive sleep apnea syndrome.
Authors and Affiliations
О. О. Крахмалова, О. М. Колеснікова, В. В. Шторх, О. А. Гетман, Ю. Є. Харченко
Keywords
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