Analiza sistemskih efekata inflamacije i težine bolesti kod obolelih od hronične opstruktivne bolesti pluća
Analysis of systemic effects of inflammation and disease severity in patients suffering from chronic obstructive pulmonary disease
Докторанд
Ćirić, ZoricaМентор
Stanković, IvanaЧланови комисије
Ristić, LidijaRančić, Milan
Lazić, Zorica
Pejčić, Tatjana
Метаподаци
Приказ свих података о дисертацијиСажетак
There is an abnormal inflammatory pulmonary response to harmful particles or gases in
chronic obstructive pulmonary disease (COPD). Pulmonary inflammation spills over into systemic
circulation which causes extra pulmonary manifestations. A large number of inflammatory
mediators are involved in establishing and maintaining of inflammatory response. The aim of the
research was the analysis of systemic effects of inflammation and COPD severity. The examination
was done in the Clinic for Pulmonary Diseases Knez Selo, Clinical Center Niš, and it involved 85
patients with COPD in a stable phase. The patients were divided into four groups: mild, moderate,
severe and very severe COPD. Serum values of C-reactive protein (CRP), tumor necrosis factor
alpha (TNF-α) and leptin were measured, BODE index was determined, and the presence of
weight loss and muscle loss, muscle dysfunction and osteoporosis were determined. We found
that with the increase in COPD severity, values of CRP, TNF-α and leptin... varied in the range
that was not statistically significant. CRP had positive, and TNF-α negative predictive influence
on COPD severity. The increase in disease severity was followed by borderline statistically
significant increase in frequency of underweight and borderline nutrition (p=0.05). Leptin values
of underweight and normal nutrition were significantly different from leptin values of pre-obese
and obese (p<0.000). Increase in disease severity was followed by significant decrease in effort
tolerance (p<0.000) and increase in dyspnoa (p<0.000). We found significant negative correlation
between 6MWT and COPD severity. Bone Mineral Density (BMD) was significantly decreased
when COPD severity was increased (p=0.26). Osteoporosis had significant negative predictive
effect on disease severity. We determined that with increase in BODE index values of CRP, TNF-α
and leptin varied in the range that was not statistically significant, and that CRP had significant
positive, and TNF-α negative correlation with BODE index values. It was found that with increase
in BODE index the number of underweight patients was significantly increased (p<0.019) along
with the frequency of osteoporosis (p=0.05), and the effort tolerance was significantly decreased
(p=0.000), while dyspnoa was increased (p=0.000). In conclusion, we may say that increase in
COPD severity is followed by increase in systemic effects, and that BODE index is a good indicator
of disease severity and systemic effects of COPD.