Коморбідні стани при хронічному обструктивному захворюванні легень: вивчені та дискусійні питання

Частина 1

Автор(и)

  • О. І. Лемко ДУ «Науково-практичний медичний центр „Реабілітація“ МОЗ України»
  • М. О. Гайсак ДУ «Науково-практичний медичний центр „Реабілітація“ МОЗ України»
  • Д. В. Решетар ДУ «Науково-практичний медичний центр „Реабілітація“ МОЗ України»

DOI:

https://doi.org/10.30978/UTJ2021-1-85

Ключові слова:

хронічне обструктивне захворювання легень, коморбідність

Анотація

Нині хронічне обструктивне захворювання легень розглядають як мультифакторне захворювання із системними позалегеневими проявами і високим рівнем коморбідності. Диференціація понять «поліморбідність» та «коморбідність» для хворих з цією патологією є вельми важливою. В основі коморбідних станів лежать спільні тригерні чинники і/або патогенетичні механізми, а їх розвиток зіставний у часі з основним захворюванням. Це зумовлює необхідність відповідного інтегрованого ведення таких пацієнтів. Наявність у пацієнта захворювань, не пов’язаних з основним патологічним процесом спільними причинними чинниками і/або патогенетичними механізмами, слід розцінювати як супутні, які є основою поліморбідності. Узагальнено дані вітчизняної та зарубіжної наукової літератури щодо механізмів розвитку можливої коморбідної патології у цього контингенту хворих. Наведено дані щодо провідної ролі оксидантного стресу та системного запалення низької інтенсивності у формуванні коморбідності при хронічному обструктивному захворюванні легень, висвітлено механізми їх впливу, взаємозв’язок і дискусійні питання, а також сучасні дані про генетичні та молекулярні механізми розвитку цих патологічних процесів. Особливу увагу приділено метаболічним порушенням, які розвиваються внаслідок оксидантного стресу та системного запалення. Зокрема показано, що системне запалення призводить до розвитку інсулінорезистентності, цукрового діабету та інших метаболічних розладів. Наведено дані щодо доцільності виділення метаболічних профілів або фенотипів, а також патогенетичне значення ендотоксикозу. Наслідком оксидантного стресу та системного запалення є також ендотеліальна дисфункція і пов’язані з нею захворювання серцево‑судинної системи. Наведено дані щодо особливостей проявів деяких з них у цього контингенту хворих.

Біографії авторів

О. І. Лемко, ДУ «Науково-практичний медичний центр „Реабілітація“ МОЗ України»

д. мед. наук, проф., головний науковий співробітник

М. О. Гайсак, ДУ «Науково-практичний медичний центр „Реабілітація“ МОЗ України»

-

Д. В. Решетар, ДУ «Науково-практичний медичний центр „Реабілітація“ МОЗ України»

-

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2021-04-14

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