Frequent combination of chronic obstructive pulmonary disease and coronary heart disease determine the relevance of further investigations of the general pathogenic mechanisms of their comorbidity and methods of effective correction of the revealed violations. The purpose of the work was to study the effectiveness of the complex treatment with the addition of omega-3 polyunsaturated fatty acids and L-arginine to the basic therapy on the content of eicosanoids - leukotriene B4 and thromboxane A2 (be the stable metabolite B2) in the blood serum and urine of patients with chronic obstructive pulmonary disease combined with coronary heart disease. Material and methods. The study included 87 patients aged (54.6 ± 3.3) with exacerbation of chronic obstructive pulmonary disease (clinical group B, GOLD II) associated with coronary heart disease (stable angina II functional class), which were divided into subgroups A and B depending on the amount of treatment. Drug therapy of patients in subgroup A consisted of the basic means according to the protocols for the treatment of both diseases; subgroup B patients additionally received omega-3 polyunsaturated fatty acids and L-arginine medications. Results and discussion. All patients underwent in addition to routine examination, and checked the levels of leukotriene (LT) B4 and thromboxane A2 (be the stable metabolite B2) in the blood serum and urine by the immunoassay method with certified reagents in the dynamics of inpatient treatment. In patients with exacerbation of chronic obstructive pulmonary disease associated with coronary artery disease, there was an increase in the concentration of LTB4 and TxB2 in the blood serum by 20.3 and 22.1 times respectively (p <0.001). On the background of complex treatment with the inclusion of omega-3 polyunsaturated fatty acids and L-arginine to the basic therapy, patients achieved a more significant decrease in the blood serum concentration of both eicosanoids while using only the basic means. Conclusion. The identified positive changes in the direction and strength of the correlation between the concentration of LTB4 and TxB2 in serum and FEV1 in patients with chronic obstructive pulmonary disease associated with coronary artery disease before and after differentiated treatment proves the effectiveness of using of omega-3 polyunsaturated fatty acids and L-arginine in the treatment of such patients.

Keywords: leukotrienes, thromboxane, chronic obstructive pulmonary disease, coronary heart disease, omega-3 polyunsaturated fatty acids, L-arginine

Full text: PDF (Ukr) 212K

1. Avdeev SN. HOBL i serdechno-sosudistyie zabolevaniya: mehanizmy i assotsiatsii. Pulmonologiya. 2008; 1: 5–13. [Russian]
2. Vyaznikova OE. Primenenie omega-3 polinenasyischennyih zhirnyih kislot v kardiologicheskoy praktike. Krovoobig ta gemostaz. 2003; 2: 35–41. [Ukrainian]
3. Shish AM, KaplInskiy SM, NagIbIn VS, ta in. Doslidzhennya mehanizmiv protizapalnoyi diyi omega-3-polinenasichenih zhirnih kislot. Patologiya. 2011; 3(8): 74–7. [Ukrainian]
4. Lapach SN, Chubenko AV, Babich PN. Statisticheskie metodyi v mediko-biologicheskih issledovaniyah s ispolzovaniem Excel. Kiev: Morion; 2000. 320 s. [Russian]
5. Leshchenko SІ, Dzyublik YaO. Porіvnyalne vivchennya zhirnokislotnogo skladu ryadu preparatіv, shcho mіstyat ω-3 ta їkh vpliv na spektr eykozanoїdіv u khvorikh na khronіchne legeneve sertse. Ukr pulmonol zhurn. 2002; 2: 244–5. [Ukrainian]
6. Mostoviy YuM, Rasputіna LV. Khronіchne obstruktivne zakhvoryuvannya legen і khronіchnі sertsevo-sudinnі zakhvoryuvannya. Fokus na antitrombotsitarnu terapіyu. Sіmeyna meditsina. 2011; 1: 41–5. [Ukrainian]
7. Voskoboy IV, Makedonskaya MV, Rossoshanskaya SI, Logvin EV. Osobennosti agregatsii trombotsitov u bolnykh ishemicheskoy boleznyu serdtsa Sb nauch tr "Sovremennyye problemy razvitiya regionalnogo zdravookhraneniya". Kazan; 2003: 175–6. [Russian]
8. Pertseva TO, Konopkіna LІ, Yakovleva VG, Voronіna NO. Osoblivostі gemostazu u khvorikh na khronіchne obstruktivne zakhvoryuvannya legen u rіznі fazi patologіchnogo protsesu. Ukr pulmonol zhurn. 2015; 2: 52–5. [Ukrainian]
9. Feshchenko YuI. Globalnaya strategiya diagnostiki, lecheniya, profilaktiki НOZL: chto novogo v 2013 godu? Zdorov’ya Ukraїni. 2013; 17(318): 45–6. [Russian]
10. Chumak YuYu. Dinamіka vmіstu tromboksanu V2 u khvorikh na bronkhіalnu astmu, poednanu z nealkogolnim steatogepatitom na tlі lіkuvannya. Zhurnal klіnіchnikh ta eksperimentalnikh medichnikh doslіdzhen. 2014; 1(2): 127-31. [Ukrainian]
11. Chuchalin AG. Khronicheskaya obstruktivnaya bolezn legkikh i soputstvuyushchiye zabolevaniya. Zdorov’ya Ukraїni. 2010; 2(231): 26–7. [Russian]
12. Shish AM. Modifіkatsіya zhirnokislotnogo skladu membran fosfolіpіdіv klіtin omega-3 polіnenasichenimi zhirnimi kislotami. Dop. NANU. 2004; 11: 184–8. [Ukrainian]
13. Shmelev EI. Sovremennyye vozmozhnosti korrektsii odyshki u bolnykh khronicheskoy obstruktivnoy boleznyu legkikh. Pulmonologiya. 2013; 6: 79–84. [Russian]
14. Yachnik AI. Infuzionnaya terapiya v profilaktike i lechenii sistemnykh proyavleniy НOZL. Mater simp «Neіntensivna terapіya u ftіzіopulmonologії ta іnshikh galuzyakh meditsini». 27-28 veresnya 2012, Donetsk. Ukr. khіmіoterapevtichniy zhurn. 2012; 3 (26): 282–4. [Russian]
15. Nishiyama К, Morimoto Т, Furukawa Y, Nakagawa Y, Ehara N, Taniguchi R, et al. Chronic obstructive pulmonary disease – an independent risk factor for long-term cardiac and cardiovascular mortality in patients with ischemic heart disease. Int J Cardiol. 2010 Aug 20; 143(2): 178-83. https://www.ncbi.nlm.nih.gov/pubmed/19368979. https://doi.org/10.1016/j.ijcard.2009.02.010
16. Calder PC. Polyunsaturated fatty acids and inflammation. Biochem Soc Transactions. 2005; 33(2): 423–7. https://www.ncbi.nlm.nih.gov/pubmed/15787620. https://doi.org/10.1042/BST0330423
17. Hooper L, Thompson RL, Harrison RA. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ. 2006; 332(7544): 752–60. https://www.ncbi.nlm.nih.gov/pubmed/16565093. https://www.ncbi.nlm.nih.gov/pmc/articles/1420708. https://doi.org/10.1136/bmj.38755.366331.2F