Chronic obstructive pulmonary disease significantly affects the quality of life, considerably limiting the physical capabilities of patients and is one of the main causes of morbidity and mortality in modern society. Currently, the problem of the comorbidity for the patients with chronic obstructive pulmonary disease is very relevant. The most common in patients of this category is hypertension. Today, it has been established that disorders in the immune system are detected in a very large group of diseases, including both chronic obstructive pulmonary disease and hypertension. The purpose of the study was to evaluate the dynamics of inflammatory markers in the patients with pulmonary hypertension on the background of chronic obstructive pulmonary disease in combination with hypertension under the influence of treatment. Material and methods. The results of the study are based on data from a comprehensive survey of 170 patients aged 40 to 65 years with chronic obstructive pulmonary disease, of which 123 had pulmonary hypertension (of which 87 had stage II hypertension and 36 were without hypertension) and 47 people were without pulmonary hypertension. The patients were chosen in the period from 2015 to 2018 on the basis of the municipal institution "Zaporizhzhia regional clinical hospital" of the Zaporizhzhia regional council. Results and discussion. The results of this study indicate the role of inflammation, or rather the levels of hs-CRP and IL-6, in the pathogenesis of pulmonary hypertension in patients with chronic obstructive pulmonary disease. The level of hs-CRP among the patients with pulmonary hypertension on a background of chronic obstructive pulmonary disease made up 10.46 [6,24 ; 15,30] mg/l and was significantly higher as against the values in the group of patients with chronic obstructive pulmonary disease without pulmonary hypertension and compared with group of healthy persons. The increase in the level of IL-6 in the group of patients having pulmonary hypertension with chronic obstructive pulmonary disease is significantly higher by 57 % compared to the value in the group of chronic obstructive pulmonary disease without pulmonary hypertension and by 7.4 times the value in the group of healthy individuals (p <0.05). Comparing the subgroups of patients, and depending on the variant of exacerbation of chronic obstructive pulmonary disease, the level of hs-CRP and IL-6 was considerably higher in the subgroup with the infectious type of exacerbation compared with the subgroup of the non-infectious type of exacerbation of chronic obstructive pulmonary disease. Conclusion. After 12 months of treatment, when roflumilast was added to the basic therapy, we revealed a statistically significant difference in the levels of IL-6, hs-CRP and IL-10 in the plasma of patients with pulmonary hypertension on the background of chronic obstructive pulmonary disease combined with hypertension

Keywords: markers of inflammation, pulmonary hypertension, chronic obstructive pulmonary disease, hypertension

Full text: PDF (Ukr) 277K

1. Dury R. COPD and emotional distress: not always noticed and therefore untreated. British journal of community nursing. 2016; 21(3): 138-141. https://doi.org/10.12968/bjcn.2016.21.3.138
2. Rodriguez-Roisin R, Rabe KF, Vestbo J, Vogelmeier C, Agustí A. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 20th anniversary: a brief history of time. European Respiratory Journal. 2017; 50: 1700671. https://doi.org/10.1183/13993003.00671-2017
3. Akramova EG. Problemy diagnostiki komorbidnykh form khronicheskoy obstruktivnoy bolezni legkikh. Nauchnoye obozreniye [Problems of diagnostics of comorbid forms of chronic obstructive pulmonary disease. Scientific Review]. Meditsinskiye nauki. 2016; 3: 5-22. [Russian]
4. Chazova IE, Lazareva NV, Oshchepkova EV. Arterial hypertension and chronic obstructive pulmonary disease: clinical characteristics and treatment efficasy (according to the national register of arterial hypertension). Therapeutic archive. 2019; 91(3): 4-10. https://doi.org/10.26442/00403660.2019.03.000110
5. Kochuyeva MM, Tymchenko HA, Zaikina YUO. Osoblyvosti protsesiv zapalennya pry kardiopulʹmonalʹniy polimorbidnosti [Features of inflammatory processes in cardiopulmonary polymorbidity]. Mizhnarodnyy medychnyy zhurnal. 2019; 1(97): 5-9. [Ukrainian]
6. Tanabe N, Taniguchi H, Tsujino I, Sakamaki F, Emoto N, Kimura H, et al. Multi-institutional retrospective cohort study of patients with severe pulmonary hypertension associated with respiratory diseases. Respirology. 2015; 20(5): 805-812. https://doi.org/10.1111/resp.12530
7. Sirenko YuM, Zhyvylo IO, Radchenko HD. Stvorennia zahalnoderzhavnoho reiestru khvorykh iz lehenevoiu hipertenziieiu - vymoha suchasnosti? [Creating a national registry of patients with pulmonary hypertension - a modern requirement?]. Ukrainskyi kardiolohichnyi zhurnal. 2016; 1: 41-46. [Ukrainian]
8. Zuo H, Xie X, Peng J, Wang L, Zhu R. Predictive value of novel inflammation-based biomarkers for pulmonary hypertension in the acute exacerbation of chronic obstructive pulmonary disease. Analytical Cellular Pathology. 2019; 2019: 5189165. https://doi.org/10.1155/2019/5189165
9. Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews. 2017; 9: CD002309. https://doi.org/10.1002/14651858.CD002309.pub5
10. Cazzola M, Rogliani P, Puxeddu E, Ora J, Matera MG. An overview of the current management of chronic obstructive pulmonary disease: can we go beyond the GOLD recommendations? Expert review of respiratory medicine. 2018; 12(1): 43-54. https://doi.org/10.1080/17476348.2018.1398086
11. Morello Gearhart A, Cavallazzi R, Peyrani P, Wiemken TL, Furmanek S, Reyes-Vega A, et al. Lung Cytokines and Systemic Inflammation in Patients with COPD. The University of Louisville Journal of Respiratory Infections. 2017; 1(4): 1-4. https://doi.org/10.18297/jri/vol1/iss4/4
12. Ardestani ME, Zaerin O. Role of serum interleukin 6, albumin and C-reactive protein in COPD patients. Tanaffos. 2015; 14(2): 134.
13. Joppa P, Petrasova D, Stancak B, Tkacova R. Systemic inflammation in patients with COPD and pulmonary hypertension. Chest. 2006; 130(2): 326-333. https://doi.org/10.1378/chest.130.2.326
14. Chaouat A, Savale L, Chouaid C, Tu L, Sztrymf B, Canuet M, et al. Role for interleukin-6 in COPD-related pulmonary hypertension. Chest. 2009; 136(3): 678-687. https://doi.org/10.1378/chest.08-2420
15. MacNee W. Systemic inflammatory biomarkers and co-morbidities of chronic obstructive pulmonary disease. Annals of medicine. 2013; 45(3): 291-300. https://doi.org/10.3109/07853890.2012.732703