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

Частина 2

Автор(и)

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

DOI:

https://doi.org/10.30978/UTJ2021-2-57

Ключові слова:

хронічне обструктивне захворювання легень, коморбідність

Анотація

У другій частині огляду детально розглядаються питання діагностики і особливостей прояву метаболічного синдрому, який є зв’язуючою ланкою між більшістю коморбідних станів у хворих на хронічне обструктивне захворювання легень. В основі метаболічного синдрому лежать інсулінорезистентність та компенсаторна гіперінсулінемія, спричинені як хронічним запаленням низької інтенсивності, так і збільшенням жирової тканини, часто на тлі обтяженої спадковості за цукровим діабетом. Висвітлено питання впливу ожиріння, кахексії та деяких ендокринних порушень на перебіг захворювання. Вказано на недостатність досліджень ендокринного статусу, особливо тиреоїдної функції та пов’язаних з ними метаболічних порушень. Розглядаються можливі патогенетичні механізми розвитку остеопорозу у зазначеного контингенту хворих. Дискутується необхідність проведення подальших досліджень патогенетичної ролі вітаміну D. Наведено дані про роль функціонального стану нирок у розвитку метаболічних розладів в організмі, хоча нині патологію нирок у хворих на хронічне обструктивне захворювання легень не розглядають як коморбідний стан. Проведено аналіз суперечливих літературних даних щодо розвитку анемії у цих пацієнтів. Наведено дані щодо розвитку онкологічних процесів при хронічному обструктивному захворюванні легень як системного прояву, проаналізовано спільні механізми розвитку цих патологічних станів, які обтяжують один одного. Звернено увагу на взаємозв’язок між гастроезофагеальною рефлюксною хворобою, бронхоектазами, обструктивним апное сну і хронічним обструктивним захворюванням легень. Окреслено перспективи сучасних генетичних досліджень при хронічному обструктивному захворюванні легень та коморбідних станах.

Біографії авторів

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

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

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

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

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2021-06-24

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