Rubtsov R. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Abstract. The study of the quality-of-life indicators and the clinical functional status is a field of research that makes it possible to determine informative criteria for the diagnosis and assessment of the efficiency of treatment of occupational bronchopulmonary pathology in employees having ore mining and steel industries’ background and suffering from pneumoconiosis in combination with the COPD. An assessment was conducted of changes in the above indicators for the said category of ill employees with a view to determining the signs of the severity of the occupational lung pathology and developing further measures aimed at its treatment and prevention.The object and methods of research. A comprehensive treatment of 25 patients with pneumoconiosis in combination with the COPD was carried out aimed at eliminating bronchial obstruction, and reducing the activity of inflammatory processes, also improving sputum expectoration, enhancing metabolism, and eliminating the hypoxia phenomena. The comparison group consisted of 29 employees who underwent a course of conventional treatment. The average age of the employees was 58.6±2.4 years, while their work experience in adverse conditions was 18.9±0.8 years. Results of the research and their discussion. It was found that after the comprehensive treatment of the ill employees, the number of lymphocytes and the erythrocyte sedimentation rate had not changed significantly. The number of leukocytes decreased by 48.3% and their rod cell subpopulations did by 19.4%, while the number of monocytes increased by 8.6% and the number of eosinophils did by 47.8%. When compared with the comparison group, it was found that the number of rod and segmented leukocytes was lower after the treatment by 1.1% and 52.7%, respectively, while their aggregate number, on the contrary, was higher by 5.2%. The number of eosinophils was also higher, viz. by 17.2%. The activity of inflammatory processes by the employees of the main group had a steady tendency to decrease by all indicators: the index of the ratio of lymphocytes to the erythrocyte sedimentation rate – by 26.4%, the ratio of leukocytes – by 16.2%, the ratio of neutrophils – by 15.3%, the ratio of non-segmented neutrophils – by 12.9%, and the overall activity index – by 15.5%. The indices that characterize the immunological status changed after the treatment: the leukocyte index increased by 83.3%, while the other ones decreased: the ratio of neutrophils to lymphocytes – by 17.4%, the ratio of neutrophils to monocytes – by 15.8%, the ratio of lymphocytes to monocytes – by 1.9%, and the ratio of lymphocytes to eosinophils – by 17.0%. When compared with the comparison group, it was found that the indices of inflammation were higher after the treatment: the ratio of lymphocytes to the erythrocyte sedimentation rate – by 13.3%, the ratio of leukocytes – by 5.1%, the ratio of neutrophils – by 4.8%, the ratio of non-segmented neutrophils – by 25.6%, and the overall activity index – by 3.7%. The indices of approximate assessment of the immune status were higher: the overall activity index – 4.4 times, the ratio of neutrophils to monocytes – by 1.0%, the ratio of lymphocytes to monocytes – by 13.0%. Other indices, on the contrary, were lower: the ratio of neutrophils to lymphocytes – by 21.7%, the ratio of lymphocytes to eosinophils – by 32.6%. Conclusions. The comprehensive treatment of ore mining and steel industries’ employees with pneumoconiosis combined with the COPD using a bronchodilator, anti-inflammatory agent, nebulizer-assisted mucoregulator, a complex vitamin B medication administered intramuscularly and hyperbaric oxygenation led to a decrease in the inflammatory activity by most of the indicators of the differential leukocyte count in the complete blood count, the activity of systemic inflammation by all the inflammation indices, and served as a stimulating factor for the systemic immunity with the predominant activation of its humoral arm. The data obtained is one of the main criteria for assessing the efficiency of the system of measures aimed at comprehensively addressing issues related to timely diagnosis, treatment and prevention of the disease. Prospects for further investigations. Obtaining new data on assessing the efficiency of the comprehensive treatment of ore mining and steel industries’ employees suffering from pneumoconiosis in combination with the COPD is the basis for creating a unified system of measures aimed at timely diagnosis, treatment and prevention of the disease, and determines the prospects for further research aimed addressing this problem.

pneumoconiosis, chronic obstructive pulmonary disease, employees, medical treatment, inflammation, immune status.

1. Makarov IA, Potapova IA, Mokeyeva NV. Osobennosti dinamiki professional khronicheskoy obstruktivnoy bolezni legkikh u rabochikh pylevykh professiy. Pulʹmonolohyya. 2017;27(1):37-40. [in Russian].
2. Shpagina LA, Poteryayeva YeL, Kotova OS, Shpagín ÍS, Smirnova ÍL. Aktual’nyye problemy pul’monologii v sovremennoy profpatologicheskoy praktike. Meditsina truda i promyshlen. ekologiya. 2015;9:11-4. [in Russian].
3. Razumov VV. K probleme traktovki sushchnosti pnevmokonioza i vozmozhnykh putyakh yeye resheniya. Meditsina truda i promyshlennaya ekologiya. 2014;10:43-8. [in Russian].
4. Radchenko OM, Pylypiv LI, Fedyk OB. Pokaznyk vidnoshennya neytrofiliv do limfotsytiv krovi pry zronichnomu obstruktyvnomu zakhvoryuvanni lehenʹ: klinichne znachennya. Ukrayinsʹkyy pulʹmonolohichnyy zhurnal. 2020;2:41-44. [in Ukrainian].
5. Panev NI, Kazitskaya AS, Korotenko OYU, Gerasimova GA, Morozova OA, Kungurova SO. Kliniko-eksperimental’ny issledovaniya immunovospalitel’nykh mekhanizmov formirovaniya pnevmokoniozov. Meditsina truda i promyshlen. ekologiya. 2020;6:364-370. [in Russian].
6. Kazitskaya AS, Mikhaylova NN, Zhukova AG, Gorokhova LG. Immunnyye mekhanizmy formirovaniya professional’noy pylevoy patologii bronkholegochn sistemy. Meditsina truda i promyshlenn. ekologiya. 2018;6:33-7. [in Russian].
7. Stepanova II, Chorbinskaya SA, Baryshnikova GA, Blokhina OYe. Rol’ dvoynoy bronkhodilyatatsii v terapii khronicheskoy obstruktivnoy bolnzni legkikh. Meditsina truda i promyshlennaya ekologiya. 2017;8:7-10. [in Russian].
8. Babkina VI, Bachinskiy OL, Plemenova YeYu. Bazisnaya terapiya obostreniy khronicheskoy obstruktivnoy bolezni legkikh (KhOBL) v sochetanii s silikozom. Materialy nauchno-prakticheskoy konferentsii. Prakticheskiy vrach. Fundamental’nyye issledovaniya. 2006;6:28-9. [in Russian].
9. Kuz’menko OV, Filimonov SN, Gordeyeva RV, Kireyeva LN, Martynova YEA. Vliyaniye rodonoteapii na epitelial’nyye kletki slizistoy obolochki respíratornogo trakta u patsiyentov s professional’noy khronicheskoy obstruktivnoy bolezn’yu legkikh. Meditsina truda i promyshlennaya ekologiya. 2020;3:195-9. [in Russian].
10. Krasnyuk OP., Tkach SI., Prylypsʹka NI, Shkondin AM., Kovalʹchuk TA., Valutsyna NI. Zastosuvannya klasyfikatsiyi pnevmokonioziv v Ukrayini: metod. rekomendatsiyi. Kyyiv; 2002, 15 s. [in Ukrainian].
11. Nakaz MOZ Ukrayiny vid 27 chervnya 2013 № 555. Pro zatverdzhennya ta vprovadzhennya medyko-tekhnolohichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomohy pry khronichnomu obstruktyvnomu zakhvoryuvanni lehenʹ. Dostupno na: http://document.ua/ prozatverdzhennja-ta-vprovadzhennja-mediko-tehnologichnih-d-doc166218.html [in Ukrainian].
12. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Poket guide to COPD diagnosis, management and prevention 2019 [Internet]. National Heart, Lung, and Blood Institute, National Institutes of Health, USA, and the World Health Organization: Global Initiative for Chronic Obstructive Lung Disease (GOLD); 2019 [updated 2019 Febr. 2; cited 2019 Febr. 25] Available from: https://goldcopd.org.

«Bulletin of problems biology and medicine» Issue 1 (159), 2021 year, 116-120 pages, index UDK 616.24-003.661+616.233-002-08-59:616-002+616.017.1]622+669

10.29254/2077-4214-2021-1-159-116-120