Assessment of the effect of the outpatient stage of pulmonary rehabilitation on endothelial function and the state of the microcirculatory system in patients with chronic obstructive pulmonary disease
Background. Over the past 10–15 years, a significant amount of evidence has been accumulated confirming the effectiveness of preventive measures at various levels in the outpatient management of patients with chronic obstructive pulmonary disease (COPD), which makes their introduction into clinical practice justified and necessary.T.V. Tayutina, A.N. Sereda, A.I. Chesnikova, V.A. Safronenko
Objective: To evaluate the impact of the developed complex of measures of the outpatient stage of pulmonary rehabilitation on endothelial function and the state of the microcirculatory system in patients with COPD.
Material and methods. 150 patients with category E COPD who suffered from a moderate exacerbation that did not require hospitalization were examined. The following groups were identified: Group 1 – 75 patients whose treatment included an outpatient rehabilitation stage with a set of measures with combined physiotherapy effects; Group 2 – 75 patients without its inclusion. To assess endothelial function and peripheral circulation, all patients underwent Doppler ultrasound with functional tests (cold and occlusive), as well as the concentration of tumor necrosis factor-alpha and platelet growth factor AA.
Results. The high clinical effectiveness of using a comprehensive outpatient rehabilitation program in studied patients with COPD was confirmed, which manifested itself in a statistically significant decrease in the level of endothelial dysfunction, improvement of peripheral blood circulation and its reduction, in the negative dynamics of the severity of clinical manifestations of the disease, and increased exercise tolerance.
Conclusion. In patients with COPD and frequent exacerbations, a rehabilitation program involving combined physiotherapeutic interventions is recommended to reduce the severity of endothelial dysfunction and normalize peripheral vascular function, thereby helping to prevent cardiovascular complications associated with the underlying disease.
Keywords
chronic obstructive pulmonary disease
endothelial function
outpatient pulmonary rehabilitation
microcirculatory system
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About the Authors
Tatyana V. Tayutina, MD, Dr. Sci. (Medicine), associate professor, associate professor of the Department of internal medicine No. 1, Rostov State Medical University, Rostov-on-Don, Russian Federation.Е-mail: tarus76@mail.ru
ORCID: https://orcid.org/0000-0002-5421-4202
Alexander N. Sereda, MD, PhD (Medicine), deputy Minister of Healthcare of the Rostov Region, Rostov-on-Don, Russian Federation.
Е-mail: sereda.a.n@yandex.ru
https://orcid.org/0000-0002-8978-9735
Anna I. Chesnikova, MD, Dr. Sci. (Medicine), professor, head of the Department of internal medicine No. 1, Rostov State Medical University, Rostov-on-Don, Russian Federation.
E-mail: rostov-ossn@yandex.ru
ORCID: https://orcid.org/0000-0002-9323-592X
Victoria A. Safronenko, MD, Dr. Sci. (Medicine), associate professor of the Department of internal medicine No. 1, Rostov State Medical University, Rostov-on-Don, Russian Federation.
E-mail: v.chugunova@mail.ru
ORCID: https://orcid.org/0000-0002-6965-5019
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