EFFECT OF THE PULMONARY REHABILITATION ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN PATIENTS WITH METABOLIC SYNDROME

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Relevance: The course of chronic obstructive pulmonary disease (COPD) is often caused by metabolic syndrome, which requires a special approach to this category of patients[1]. The comorbid course of these pathologies has a negative effect on the severity of the disease, worsens the prognosis of the course, reduces the life expectancy of such patients[2, 3]. These factors significantly increase the number of hospitalizations, which increases the cost of treatment, cause an increase in disability and mortality [4]. Of particular relevance is the improvement of clinical effective therapy of pregnant patients, the modernization of pulmonary rehabilitation (LR) programs, which include physical training of the respiratory muscles.

Objective: Development and integration of a comprehensive innovative system of methods for the rehabilitationof comorbid patients suffering from COPD and metabolic syndrome, including a theoretical training program, generalphysical training and the use of a computer system for training the respiratory muscles.

Materials and methods: A total of 184 patients diagnosed with COPD and metabolic syndrome (106 men, 78women; mean age 48.36 ± 0.32 years) were selected for the research. The first group (104 people) included patientsdiagnosed with high-severity HOBL and metabolic syndrome, whose treatment program included a pulmonaryrehabilitation program and standard drug therapy for COPD patients; The second group (80 hours), which includedpatients receiving only standard drug therapy, was a control group. With the help of the computer program "(Pulmosys)" a survey of the severity of the course of COPD was carried out. This program included the following indicators: the numberof exacerbations of the disease during the year, the number of hospitalizations during the year.

Results: During the research, the first group of comorbid patients, whose treatment program included both LR and standard drug therapy, showed a statistically significant positive trend compared to the control group. In the first group, exercise tolerance (6MWT) increased statistically significantly, clinical and laboratory-instrumental parameters improved, the severity of clinical symptoms, the degree of effect of shortness of breath on health, as well as the number of exacerbations and hospitalizations during the year of observation.

Discussion: Conducting complex therapy in patients with COPD and the presence of metabolic syndrome  leads to a decrease in the number of exacerbations and hospitalizations for the underlying disease, the severity of their clinical symptoms, a decrease in the systemic inflammatory response. During the research, a  positive effect on the  underlying disease was noted. psycho-emotional status, improvement of the quality of life of this category of patients and subjective positive emotional impact on the perception of the disease.

Conclusion: The inclusion of the pulmonary rehabilitation program in the management scheme of patients with a comorbid course of COPD and metabolic syndrome, the optimization of therapeutic and preventive measures statistically significantly improves the quality of life of such patients and the prognosis of the course of the disease.

About the authors

Alexander V. Pertsev

Voronezh State Medical University named after N. N. Burdenko

Email: pertsev.vrn@yandex.ru
ORCID iD: 0000-0001-8984-1831
SPIN-code: 1432-9076
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia

Yuliya О. Glavatskikh

Voronezh State Medical University named after N. N. Burdenko

Author for correspondence.
Email: Yuliyag36@gmail.com
ORCID iD: 0000-0002-2398-5987
SPIN-code: 9762-6156
Russian Federation, 10 Studentskaya str., Voronezh, 394036, Russia

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