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ȾɁ «Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤɚ ɞɟɪɠɚɜɧɚ ɦɟɞɢɱɧɚ ɚɤɚɞɟɦɿɹ ɆɈɁ ɍɤɪɚʀɧɢ» (ɡɚɜ. - ɱɥɟɧ-ɤɨɪ. ɇȺɆɇ ɍɤɪɚʀɧɢ, ɞ. ɦɟɞ. ɧ., ɩɪɨɮ. Ɍ.Ɉ. ɉɟɪɰɟɜɚ) ɜɭɥ. Ⱦɡɟɪɠɢɧɫɶɤɨɝɨ, 9, Ⱦɧɿɩɪɨɩɟɬɪɨɜɫɶɤ, 49044, ɍɤɪɚʀɧɚ
SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine» Department of faculty therapy and endocrinology
Dzerzhinsky str., 9, Dnipropetrovsk, 49044, Ukraine e-mail: mihailichenkod@mail.ru
Ʉɥɸɱɨɜɿɫɥɨɜɚ ɯɪɨɧɿɱɧɟ ɨɛɫɬɪɭɤɬɢɜɧɟ ɡɚɯɜɨɪɸɜɚɧɧɹ ɥɟɝɟɧɶ, ɫɢɫɬɟɦɧɟ ɡɚɩɚɥɟɧɧɹ, ɋ-ɪɟɚɤɬɢɜɧɢɣ ɩɪɨɬɟʀɧ
.H\ZRUGVchronic obstructive pulmonary disease, systemic inflammation, C-reactive protein
ɊɟɮɟɪɚɬȼɡɚɢɦɨɫɜɹɡɶɤɥɢɧɢɤɨɚɧɬɪɨɩɨɦɟɬɪɢɱɟɫɤɢɯɞɚɧɧɵɯɢɫɢɫɬɟɦɧɨɝɨɜɨɫɩɚɥɟɧɢɹɭɛɨɥɶɧɵɯɏɈɁɅ ɉɟɪɰɟɜɚɌȺɆɢɯɚɣɥɢɱɟɧɤɨȾɋ ȼ ɩɨɫɥɟɞɧɟɟ ɜɪɟɦɹ ɡɧɚɱɢɬɟɥɶɧɨɟ ɜɧɢɦɚɧɢɟ ɭɞɟɥɹɟɬɫɹ ɢɡɭɱɟɧɢɸ ɫɢɫɬɟɦɧɨɝɨ ɜɨɫɩɚɥɟɧɢɹ ɭ ɛɨɥɶɧɵɯ ɯɪɨɧɢɱɟɫɤɢɦ ɨɛɫɬɪɭɤɬɢɜɧɵɦ ɡɚɛɨɥɟɜɚɧɢɟɦ ɥɟɝɤɢɯ (ɏɈɁɅ). ɐɟɥɶɸ ɧɚɲɟɝɨ ɢɫɫɥɟɞɨɜɚɧɢɹ ɛɵɥɨ ɭɫɬɚɧɨɜɢɬɶ ɜɡɚɢɦɨɫɜɹɡɶ ɦɟɠɞɭ ɤɥɢɧɢɤɨ-ɚɧɬɪɨɩɨɦɟɬɪɢɱɟɫɤɢɦɢ, ɚɧɚɦɧɟɫɬɢɱɟɫɤɢɦɢ ɞɚɧɧɵɦɢ ɢ ɭɪɨɜɧɟɦ ɫɢɫɬɟɦɧɨɝɨ ɜɨɫɩɚɥɟɧɢɹ ɭ ɛɨɥɶɧɵɯ ɏɈɁɅ ɜ ɫɬɚɛɢɥɶɧɭɸ ɮɚɡɭ ɩɚɬɨɥɨɝɢɱɟɫɤɨɝɨ ɩɪɨɰɟɫɚ. ɉɨ ɪɟɡɭɥɶɬɚɬɚɦ ɢɫɫɥɟɞɨɜɚɧɢɹ ɭ 44% ɛɨɥɶɧɵɯ ɏɈɁɅ ɨɛɧɚɪɭɠɢɥɢ ɩɨɜɵɲɟɧɧɵɣ ɭɪɨɜɟɧɶ ɋɊɉ (7,9 [7,1-10,9). ɉɨɤɚɡɚɬɟɥɶ ɛɵɥ ɞɨɫɬɨɜɟɪɧɨ ɜɵɲɟ ɩɨ ɫɪɚɜɧɟɧɢɸ ɫɨ ɡɞɨɪɨɜɵɦɢ (ɪ=0,04). ɇɚ ɩɨɜɵɲɟɧɢɟ ɭɪɨɜɧɹ ɋɊɉ ɜ ɫɬɚɛɢɥɶɧɭɸ ɮɚɡɭ ɡɚɛɨɥɟɜɚɧɢɹ ɜɥɢɹɸɬ: ɫɬɟɩɟɧɶ ɬɚɛɚɱɧɨɣ ɧɚɝɪɭɡɤɢ ɩɨ ɢɧɞɟɤɫɭ ɩɚɱɤɚ/ɥɟɬ (p = 0,032), ɞɥɢɬɟɥɶɧɨɫɬɶ ɡɚɛɨɥɟɜɚɧɢɹ (p=0,01). ɇɟ ɭɫɬɚɧɨɜɥɟɧɚ ɫɜɹɡɶ ɦɟɠɞɭ ɭɪɨɜɧɟɦ ɋɊɉ ɢ ɪɨɫɬɨɦ, ɜɟɫɨɦ, ɎȼȾ, ɫɬɚɞɢɟɣ ɢ ɤɚɬɟɝɨɪɢɟɣ ɡɚɛɨɥɟɜɚɧɢɹ. ɍɪɨɜɟɧɶ ɋɊɉ ɜɥɢɹɥ ɧɚ ɱɚɫɬɨɬɭ ɨɛɨɫɬɪɟɧɢɣ. Ȼɨɥɶɧɵɟ ɫ ɩɨɜɵɲɟɧɧɵɦ ɭɪɨɜɧɟɦ ɋɊɉ ɢɦɟɥɢ ɞɨɫɬɨɜɟɪɧɨ ɛɨɥɶɲɟɟ ɤɨɥɢɱɟɫɬɜɨ ɨɛɨɫɬɪɟɧɢɣ ɡɚ ɩɪɨɲɟɞɲɢɣ ɝɨɞ (r=0,50; p=0,01). ɍ ɛɨɥɶɧɵɯ, ɤɨɬɨɪɵɟ ɩɪɢɧɢɦɚɸɬ ɥɸɛɭɸ, ɧɨ ɩɨɫɬɨɹɧɧɭɸ ɬɟɪɚɩɢɸ, ɭɪɨɜɟɧɶ ɋɊɉ ɧɢɠɟ, ɱɟɦ ɭ ɬɟɯ, ɤɬɨ ɩɨɫɬɨɹɧɧɨ ɬɟɪɚɩɢɸ ɧɟ ɩɪɢɧɢɦɚɟɬ.
$EVWUDFW5HODWLRQEHWZHHQFOLQLFDODQGDQWKURSRPHWULFGDWDDQGV\VWHPLFLQIODPPDWLRQLQSDWLHQWVZLWK&23' 3HUWVHYDɌȺ0\NKDLO\FKHQNR'6 Recently, much attention is devoted to systemic inflammation in patients with chronic obstructive pulmonary disease (COPD). The aim of our study was to determine the relationship between clinical and anthropometric data with systemic inflammation in stable COPD patients. According to the study CRP levels were raised in 44% of patients (7.9 [7,1-10,9). Serum CRP was significantly higher in stable COPD patients than in control subjects (p=0.04). CRP correlated well with the pack/years index(p = 0,032) and disease duration (p=0,01). It wasn’t established link between CRP levels and height, weight, stage, disease category. CRP level affected the frequency of exacerbations (r=0,50; p=0,01). Patients with high CRP level had significantly more exacerbations in the past year (p=0.01). Patients who received any type of therapy for a long period of time had lower CRP levels, than patients who did not reseive any therapy.
ȺɤɬɭɚɥɶɧɿɫɬɶɈɫɬɚɧɧɿɦ ɱɚɫɨɦ ɡɧɚɱɧɚ ɭɜɚɝɚ ɩɪɢɞɿɥɹɽɬɶɫɹ ɜɢɜɱɟɧɧɸ ɫɢɫɬɟɦɧɨɝɨ ɡɚɩɚɥɟɧɧɹ ɭ ɯɜɨɪɢɯ ɧɚ ɯɪɨɧɿɱɧɟ ɨɛɫɬɪɭɤɬɢɜɧɟ ɡɚɯɜɨɪɸɜɚɧɧɹ ɥɟɝɟɧɶɏɈɁɅɹɤɟɽɨɫɧɨɜɧɢɦɱɢɧɧɢɤɨɦɩɨɹɜɢ ɩɨɡɚɥɟɝɟɧɟɜɢɯɟɮɟɤɬɿɜɩɨɝɿɪɲɟɧɧɹɩɪɨɝɧɨɡɭɞɥɹ ɩɚɰɿɽɧɬɚɬɚɡɧɢɠɟɧɧɹɹɤɨɫɬɿɠɢɬɬɹ>@
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ɪɚɧɬɧɿɫɬɸɞɨɮɿɡɢɱɧɨɝɨɧɚɜɚɧɬɚɠɟɧɧɹ>@
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ɆȺɌȿɊȱȺɅɂɌȺɆȿɌɈȾɂȾɈɋɅȱȾɀȿɇɖ
Ⱦɨ ɞɨɫɥɿɞɠɟɧɧɹ ɛɭɥɨ ɜɤɥɸɱɟɧɨ ɚɦɛɭɥɚ ɬɨɪɧɢɯɯɜɨɪɢɯɡɭɫɬɚɧɨɜɥɟɧɢɦɞɿɚɝɧɨɡɨɦɏɈɁɅɭ ɫɬɚɛɿɥɶɧɭɮɚɡɭɩɚɬɨɥɨɝɿɱɧɨɝɨɩɪɨɰɟɫɭɱɨɥɨɜɿɤɿɜ ɛɭɥɨɠɿɧɨɤ±ɫɟɪɟɞɧɿɣɜɿɤɫɬɚ ɧɨɜɢɜ ɪɨɤɭ Ɏɨɪɦɭɜɚɧɧɹ ɞɿɚɝɧɨɡɭ ɏɈɁɅɩɪɨɜɨɞɢɥɢɡɝɿɞɧɨɡɇɚɤɚɡɨɦɆɈɁɍɤɪɚʀɧɢ ʋ ɜɿɞ ɪɨɤɭ >@ ɍɫɿ ɯɜɨɪɿ ɞɚɥɢ ɩɢɫɶɦɨɜɭ ɡɝɨɞɭ ɧɚ ɩɪɨɜɟɞɟɧɧɹ ɞɨɫɥɿɞɠɟɧɧɹɍ ɤɨɧɬɪɨɥɶɧɭ ɬɪɟɬɸ ɝɪɭɩɭ ɛɭɥɨ ɜɤɥɸɱɟɧɨ ɩɪɚɤɬɢɱɧɨɡɞɨɪɨɜɢɯɞɨɛɪɨɜɨɥɶɰɿɜɹɤɿɧɿɤɨɥɢɧɟ ɤɭɪɢɥɢ ɡ ɧɨɪɦɚɥɶɧɢɦɢ ɩɨɤɚɡɧɢɤɚɦɢ ɮɭɧɤɰɿʀ ɡɨɜɧɿɲɧɶɨɝɨɞɢɯɚɧɧɹɎɁȾ
Ⱦɨ ɞɨɫɥɿɞɠɟɧɧɹ ɧɟ ɜɤɥɸɱɚɥɢɫɶ ɯɜɨɪɿ ɹɤɿ ɦɚɥɢ ɝɨɫɬɪɿ ɡɚɩɚɥɶɧɿ ɡɚɯɜɨɪɸɜɚɧɧɹ ɬɚ ɬɹɠɤɭ ɯɪɨɧɿɱɧɭɩɚɬɨɥɨɝɿɸ
ɍ ɞɨɫɥɿɞɠɟɧɧɿ ɚɧɚɥɿɡɭɜɚɥɢ ɤɥɿɧɿɤɨɚɧɚɦɧɟ ɫɬɢɱɧɿɞɚɧɿɭɜɫɿɯɯɜɨɪɢɯɜɢɡɧɚɱɚɥɢɫɶɩɨɤɚɡɧɢɤɢ ɎɁȾɡɚɞɨɩɨɦɨɝɨɸɫɩɿɪɨɝɪɚɮɚ0DVWHU/DE-DHJHU ɇɿɦɟɱɱɢɧɚ ɚɧɚɥɿɡɭɜɚɥɢɫɹ ɪɿɜɧɿ ɨɛ¶ɽɦɭ ɮɨɪɫɨ ɜɚɧɨɝɨ ɜɢɞɢɯɭ ɡɚ ɩɟɪɲɭ ɫɟɤɭɧɞɭ ɈɎȼ ɮɨɪ
ɫɨɜɚɧɨʀ ɠɢɬɬɽɜɨʀ ɽɦɧɨɫɬɿ ɥɟɝɟɧɶ ɎɀȯɅ ɫɩɿɜ ɜɿɞɧɨɲɟɧɧɹ ɈɎȼɎɀȯɅ ɩɪɨɜɨɞɢɜɫɹ ɬɟɫɬ ɧɚ
ɡɜɨɪɨɬɧɿɫɬɶ ɛɪɨɧɯɿɚɥɶɧɨʀ ɨɛɫɬɪɭɤɰɿʀ ɡ ȕɚɝɨ
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ɧɨʀɝɪɭɩɢS ɬɨɞɿɹɤɪɿɡɧɢɰɹɦɿɠɪɿɜɧɟɦ
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S ɪɢɫ ɿɧɞɟɤɫɨɦ ɩɚɱɤɚɪɿɤ U S ɪɢɫ ɤɿɥɶɤɿɫɬɸ ɡɚɝɨɫɬɪɟɧɶ ɡɚ ɦɢɧɭ ɥɢɣɪɿɤU S ɪɢɫ
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Ʌɿɤɭɜɚɧɧɹɨɛɫɬɟɠɟɧɢɯɯɜɨɪɢɯɝɪɭɩ
ɉɨɤɚɡɧɢɤɢ ȽɪɭɩɚQ ȽɪɭɩɚQ Ɋ
Ɇɟɞɢɤɚɦɟɧɬɨɡɧɨɩɨɫɬɿɣɧɨɧɟɥɿɤɭɜɚɥɢɫɹ
ɋɚɥɶɦɟɬɟɪɨɥɮɥɸɬɢɤɚɡɨɧ
Ȼɟɤɥɨɦɟɬɚɡɨɧ
ȱɩɪɚɬɪɨɩɿɸɛɪɨɦɿɞɮɟɧɨɬɟɪɨɥ
Ɍɿɨɬɪɨɩɿɸɛɪɨɦɿɞ
ȼɂɋɇɈȼɄɂ
ɋɟɪɟɞ ɨɛɫɬɟɠɟɧɢɯ ɤɥɿɧɿɱɧɨ ɨɞɧɨɪɿɞɧɢɯ ɯɜɨɪɢɯ ɧɚ ɏɈɁɅ ɭ ɫɬɚɛɿɥɶɧɭ ɮɚɡɭ ɩɟɪɟɛɿɝɭ ɜ ɯɜɨɪɢɯ ɜɢɹɜɢɥɢ ɩɿɞɜɢɳɟɧɢɣ ɪɿɜɟɧɶ ɋɊɉ >±ɉɨɤɚɡɧɢɤɛɭɜɞɨɫɬɨɜɿɪɧɨɜɢɳɢɣ ɩɨɪɿɜɧɹɧɨɡɿɡɞɨɪɨɜɢɦɢɪ
Ɂɚ ɞɚɧɢɦɢ ɧɚɲɨɝɨ ɞɨɫɥɿɞɠɟɧɧɹ ɧɚ ɩɿɞɜɢ ɳɟɧɧɹ ɪɿɜɧɹ ɋɊɉ ɭ ɫɬɚɛɿɥɶɧɭ ɮɚɡɭ ɩɟɪɟɛɿɝɭ ɡɚɯɜɨɪɸɜɚɧɧɹ ɜɩɥɢɜɚɸɬɶ ɬɸɬɸɧɨɜɟ ɧɚɜɚɧɬɚ ɠɟɧɧɹ ɡɚ ɿɧɞɟɤɫɨɦ ɩɚɱɤɚɪɿɤ S ɬɪɢɜɚ ɥɿɫɬɶɡɚɯɜɨɪɸɜɚɧɧɹS ɇɟɜɫɬɚɧɨɜɥɟɧɨ
ɡɜ¶ɹɡɤɭɦɿɠɪɿɜɧɟɦɋɊɉɬɚɡɪɨɫɬɨɦɜɚɝɨɸɎɁȾ ɫɬɚɞɿɽɸɤɚɬɟɝɨɪɿɽɸɡɚɯɜɨɪɸɜɚɧɧɹ
ɊɿɜɟɧɶɋɊɉɜɩɥɢɜɚɜɧɚɱɚɫɬɨɬɭɡɚɝɨɫɬɪɟɧɶ U S ɏɜɨɪɿɡɩɿɞɜɢɳɟɧɢɦɪɿɜɧɟɦɋɊɉ ɦɚɥɢ ɞɨɫɬɨɜɿɪɧɨ ɛɿɥɶɲɭ ɤɿɥɶɤɿɫɬɶ ɡɚɝɨɫɬɪɟɧɶ ɡɚ ɦɢɧɭɥɢɣɪɿɤɪ
ɍ ɯɨɞɿ ɞɨɫɥɿɞɠɟɧɧɹ ɜɫɬɚɧɨɜɥɟɧɨ ɳɨ ɭ ɯɜɨɪɢɯ ɹɤɿ ɩɪɢɣɦɚɸɬɶ ɛɭɞɶɹɤɭ ɚɥɟ ɩɨɫɬɿɣɧɭ ɬɟɪɚɩɿɸ ɪɿɜɟɧɶ ɋɊɉ ɧɢɠɱɢɣ ɧɿɠ ɭ ɯɜɨɪɢɯ ɹɤɿ ɩɨɫɬɿɣɧɨɛɚɡɢɫɧɭɬɟɪɚɩɿɸɧɟɩɪɢɣɦɚɸɬɶ
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