The Effect of Differentiated Therapy on the Condition of Eicosanoids in Patients with Chronic Obstructive Pulmonary Disease Combined with Ischemic Heart Disease

Frequent combination of chronic obstructive pulmonary disease and coronary heart disease determine the relevance of further investigations of the general pathogenic mechanisms of their comorbidity and methods of effective correction of the revealed violations. The purpose of the work was to study the effectiveness of the complex treatment with the addition of omega-3 polyunsaturated fatty acids and L-arginine to the basic therapy on the content of eicosanoids - leukotriene B4 and thromboxane A2 (be the stable metabolite B2) in the blood serum and urine of patients with chronic obstructive pulmonary disease combined with coronary heart disease. Material and methods. The study included 87 patients aged (54.6 ± 3.3) with exacerbation of chronic obstructive pulmonary disease (clinical group B, GOLD II) associated with coronary heart disease (stable angina II functional class), which were divided into subgroups A and B depending on the amount of treatment. Drug therapy of patients in subgroup A consisted of the basic means according to the protocols for the treatment of both diseases; subgroup B patients additionally received omega-3 polyunsaturated fatty acids and L-arginine medications. Results and discussion. All patients underwent in addition to routine examination, and checked the levels of leukotriene (LT) B4 and thromboxane A2 (be the stable metabolite B2) in the blood serum and urine by the immunoassay method with certified reagents in the dynamics of inpatient treatment. In patients with exacerbation of chronic obstructive pulmonary disease associated with coronary artery disease, there was an increase in the concentration of LTB4 and TxB2 in the blood serum by 20.3 and 22.1 times respectively (p <0.001). On the background of complex treatment with the inclusion of omega-3 polyunsaturated fatty acids and L-arginine to the basic therapy, patients achieved a more significant decrease in the blood serum concentration of both eicosanoids while using only the basic means. Conclusion. The identified positive changes in the direction and strength of the correlation between the concentration of LTB4 and TxB2 in serum and FEV1 in patients with chronic obstructive pulmonary disease associated with coronary artery disease before and after differentiated treatment proves the effectiveness of using of omega-3 polyunsaturated fatty acids and L-arginine in the treatment of such patients.