The process of recovery after an exacerbation of chronic bronchitis (ChB) means the generally accepted pathogenic therapy of most often runs for several weeks, while, on the part of convalescents in the future may experience residual effects in the form of postinfectious asthenia. The aim of the study was to investigate the effect of combination of sodium desoxyribonucleate and vitamin-antioxidant coplex with selenium on the phagocytic activity of monocytes (PhAM), the intensity of lipid peroxidation (LPO) and the metabolism of nitroxide (NO) in patients with co-morbid for ChB (exacerbation) and peptic ulcers of the duodenum (PDU). Object and methods of research. We examined 76 patients with ChB (exacerbation) in combination with the PDU in age from 25 to 59 years old (37,4±1,4 years), from them 40 persons — men (52,6%) and 36 women (47,4 %). The complex treatment of patients of the main group (45 patients), along with the conventional means, was added of sodium desoxyribonucleate (Derinat) of 1,5% solution (5,0 ml intramuscular once a day for 5 days, followed by 5,0 ml intramuscular once time per three days 5 injections) in combination with the vitamin-antioxidant complex (Triovit) — 2 caps/day; 31 patients in the comparison group received conventional treatment. Twice (at the beginning of treatment and on its completion) investigated PhAM peripheral blood (assessed by phagocytic index (PI), phagocytic number (PhN), the index of attraction (IA) and the index of digestion (ID); activity of lipid peroxidation (LPO) (content in serum diene conjugate (DC) and malonic dialdehyde (MDA) and metabolism of nitric oxide (on the content of stable metabolites in plasma (NO2, NO3) and their sum (NOx); control group to define the norm of immunological and metabolic parameters consisted of 15 practically healthy persons. The results obtained and their discussion. It is revealed that before treatment patients had violations PhAM: reduce PhI more than 1,5 times (P<0,001), decreased PhN, IA – about 1,4 times (P<0,001); the proportion of ID in the main group and the comparison group was reduced almost twice (P<0,001). All patients showed (P<0,001) increase blood level of DC (2,2 fold) and MDA (2,9 times), reduction of NO2, NO3, and their total level was decreased more than in 3 times (P<0,001). Re-examination (after treatment) it is shown that in the main group there was an increase in the PhI 1,52 times (P<0,001) – from 16,8±0,8% to 25,6±1,1% (in the comparison group – 1,12; P>0.05), PhN 1.46 fold (from 2,8±0,06 to 4,1±0,25; P<0,01), IA – 1,27 times (from 10,9±0,8% to 13,8±0,6%; P<0,05) and ID (to 24,6±1,5%; P<0,001), reaching values of the reference standards (in the comparison group – in 1,31 times (P<0,05) — to 18,1±0,8%). In the dynamics of treatment changes of LPO products: in the main group there was a decrease of the content as a DC in 2 times (from 20,2±0,4 µmol/l to 10,4±0,5 μmol/l; P<0,001) and MDA – 1,7 times (from 9,7±0,3 µmol/l to 5,6±0,3 μmol/l; P<0,001), and the content of both metabolites were significantly (P<0,05) lower than that of patients of group (15,2±0,6 µmol/l and 7,2±0,3 μmol/l, respectively). Furthermore, after patients of the main group showed a significant (P<0,001) increase in the content of stable metabolites of nitroxide, which is reflected in the increase of NOx (from 17,9±1,2 μmol/l to 25,0±1,7 μmol/l), while its value was higher than patients in the comparison group (18,8±1,3 µmol/l), and the differences with the reference norm was erased. Note also that in main group of patients the long-term preservation of clinical remission CB was higher. Сonclusion. In patients with ChB (exacerbation) in combination with the PDU are the decline PhAM, as a reflection of violations of the macrophage phagocytic system. This is combined with a significant increase in the blood levels of the lipide peroxidation products (DC, MDA) and a decrease in the content of stable metabolites of nitroxide. Application in treatment combinations of sodium desoxyribonucleate and vitamin-antioxidant complex with selenium, compared with conventional treatment, and facilitates more significant dynamics of normalization indicators of PhAM, LPO and metabolism of NO, and increase the time of clinical and laboratory remission ChB.
