TNF-α LEVELS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN CONNECTION WITH GASTROPATHY AFTER TREATMENT OF THIS COMORBID PATHOLOGY
DOI:
https://doi.org/10.11603/1811-2471.2019.v0.i1.10069Keywords:
tumour necrosis factor alpha, chronic obstructive pulmonary disease, gastropathyAbstract
Chronic obstructive pulmonary disease (COPD) takes 4th place in the structure of therapeutic pathology. Gastropathy is one of the extrapulmonary manifestations of COPD. Nevertheless, the mechanisms of mutual weighting of COPD and gastroduodenal pathology are not fully investigated.
The aim of the study – to learn the change of the TNF-α level in COPD patients with erosive-ulcerative lesions in the gastroduodenal area in the course of COPD treatment combined with rabeprazole and rebamipide therapies.
Material and Methods. The cohort of 88 patients was examined. 21 patients had COPD comorbid with erosive-ulcerative lesions in the gastroduodenal area (group I). Group II included 26 patients whose background COPD therapy was combined with rabeprazole as an anti-helicobacter therapy, while 27 patients with the same pathology who made up group III were prescribed rabeprazole and rebamipide in addition to the background therapy for the underlying condition. The control group consisted of 14 practically healthy persons.
All patients were examined with next general-clinical investigations, spirometry, fibrogastroduodenoscopy, and TNF-α levels were determined by the immunological method.
Results and Discussion. As compared to the control group, a significant increase in the TNF-α level in the patients with the comorbidity was observed. The prescription of rabeprazole as an anti-helicobacter therapy for ten days to the patients with the comorbidity in addition to the COPD background therapy resulted in a considerable reduction of the TNF-α level to (34.48±8.98) pg/mL (р<0.01). Using rabeprazole+rebamipide anti-helicobacter therapy for ten days in combination with the COPD background therapy also brought about a significant decrease in the TNF-α level down to (38.25±7.78) pg/mL (р<0.01).
Conclusions. Addition of rabeprazole or rabeprazole+rebamipide to the background therapy of COPD comorbid with gastroduodenal pathology reduced the gastric and duodenal clinical manifestations, which was objectively verified by the OGD data and was displayed in the reduced or eliminated erosive-ulcerative defects in the gastroduodenal area. Using rabeprazole or rabeprazole with rebamipide in addition to the background therapy of the underlying disease resulted in a significant decrease in the TNF-α level and improved general condition of the patients.
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