Volume 04 Issue 10-2024
14
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
10
P
AGES
:
14-19
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
This study investigates the laboratory parameters in patients with chronic cerebral ischemia (CCI) in relation to the
presence of concomitant chronic obstructive pulmonary disease (COPD). CCI is characterized by a progressive
reduction in cerebral blood flow, while COPD can exacerbate hypoxia, potentially worsening brain ischemia. The
research evaluates blood biomarkers, including inflammatory markers and oxygenation indices, to determine the
impact of COPD on CCI patients. Results suggest that patients with both CCI and COPD present with more severe
inflammatory responses and lower oxygenation levels, which may influence the progression of cerebral ischemia and
overall prognosis.
KEYWORDS
Chronic cerebral ischemia, chronic obstructive pulmonary disease, laboratory parameters, hypoxia, inflammation,
oxygenation, comorbidity.
INTRODUCTION
Research Article
LABORATORY PARAMETERS IN PATIENTS WITH CHRONIC CEREBRAL
ISCHEMIA DEPENDING ON THE PRESENCE OF CONCOMITANT CHRONIC
OBSTRUCTIVE PULMONARY DISEASE
Submission Date:
Sep 29, 2024,
Accepted Date:
Oct 04, 2024,
Published Date:
Oct 09, 2024
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume04Issue10-03
L.M. Zakirova
Andijan State Medical Institute, Uzbekistan
J.A. Nazarova
Center for the Development of Professional Qualifications of Medical Workers of the Ministry of Health of the
Republic of Uzbekistan, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 10-2024
15
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
10
P
AGES
:
14-19
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Chronic obstructive pulmonary disease (COPD) is one
of the leading causes of morbidity and mortality
worldwide. According to a number of studies, the
prevalence of COPD in the adult population is 5
–
9% (1).
COPD is a common cause of visits to a doctor,
hospitalizations and intensive care units. This is the
only disease whose mortality continues to increase.
Mortality from COPD ranks 4th among all causes of
death in the general population, accounting for about
4% of the overall mortality structure [3].
There are no clear ideas about the nature of
neurological complications in patients with COPD, the
features of blood flow and neuro-visualization changes
in the brain depending on the stage of the disease have
not been sufficiently studied. Clinical and diagnostic
features of the clinical picture in patients with chronic
cerebral ischemia depending on the presence of
concomitant chronic obstructive pulmonary disease,
laboratory indicators and acid-base balance indicators,
as well as the function of external respiration have not
been sufficiently studied.
Aim of the study:
To study laboratory parameters in
patients with chronic cerebral ischemia depending on
the presence of concomitant chronic obstructive
pulmonary disease.
METHODS
Over a period of 3 years, patients were selected: 1)
patients with CCI stage II with concomitant COPD
(main group - MG); 2) patients with CCI stage II without
COPD (comparison group - CG). The control group (CG)
included 20 patients, 10 men and 10 women, average
age 63.1±6.4 years (Table 1).
Table.1.
Distribution of patients by groups, gender and age
Groups
gender
Age, WHO, 2022
60 - 74 years
old
75 - 90 years
old
total
M
abs
13
21
34
MG
%
38,2%
61,8%
59,6%
n=57
F
abs
9
14
23
%
39,1%
60,9%
40,4%
Total
abs
22
35
57
%
38,6%
61,4%
47,5%
Volume 04 Issue 10-2024
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International Journal of Medical Sciences And Clinical Research
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2771-2265)
VOLUME
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ISSUE
10
P
AGES
:
14-19
OCLC
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1121105677
Publisher:
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M
abs
9
18
27
CG
%
33,3%
66,7%
42,9%
n=63
F
abs
12
24
36
%
33,3%
66,7%
57,1%
total
абс
21
42
63
%
33,3%
66,7%
52,5%
м
abs
22
39
61
Total
%
36,1%
63,9%
50,8%
n=120
ж
abs
21
38
59
%
35,6%
64,4%
49,2%
total
abs
43
77
120
%
35,8%
64,2%
100,0%
Note: OG – main group; CG – comparison group; m – men; f – women; abs – absolute values;
WHO – World Health Organization.
The MG comprised 57 patients (47.5%) and the CG
comprised 63 patients (52.5%). As can be seen from
Table 1, the MG had a predominance of males - 34
(59.6%) versus females - 23 (40.4%) (p < 0.05). In the CG,
there was a predominance of women - 36 (57.1%), the
proportion of men was 42.9% (p < 0.05). The groups
were dominated by elderly people according to WHO,
2022.
The diagnosis and stages of CIM were established
according to generally accepted criteria for the
Republic
after
conducting
thorough
clinical,
neurological, neuropsychological and instrumental
(duplex scanning, MRI of the brain) studies (2).
The diagnosis of COPD was made on the basis of
complaints (shortness of breath, cough with sputum),
clinical picture of the disease, anamnestic data
(presence of risk factors), results of physical and
laboratory examination methods, instrumental data
(measurements of airflow limitation (spirometry) - the
ratio of FEV1 / FVC < 70%; post-bronchodilator value of
FEV1 less than 80% of the expected) in accordance with
the “Global strategy for the diagnosis, treatment and
prevention of chronic obstructive pulmonary disease”
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(National Heart, Lung, and Blood Institute; revision
2008) and the “Respiratory Medicine Guidelines” (4).
All patients underwent a standard clinical and
neurological examination
(analysis of patient
complaints, life history and medical history, objective
examination, including study of neurological status)
and somatic examination, laboratory research
methods.
Statistical processing of the research results was
carried out using variation statistics methods using
Microsoft Office Excel-2019 programs.
RESULTS
In the MG, there was a tendency towards an increase
in the hemoglobin level - 147.5±19.7 g/l compared to the
CG - 126.2+14.1 g/l.
Figure 1. Hematocrit values (%).
Notes: significance of differences * p < 0.05 between groups.
A significant difference was found between the groups
(p>0.05). The hematocrit index was significantly
(p<0.05) higher in the MG - 46.1+6.6%, compared to the
CG - 44.3±3.1% (p>0.05) (Fig. 1). The values of the
erythrocyte level did not differ significantly and were in
the MG - 4.9±0.41012/L; in the CG - 4.3±1.61012/L. The
number of platelets did not differ significantly: in the
MG - 229.9±67.9X109/L, in the CG - 189.4±123.8X109/L.
The level of leukocytes differed in different groups: in
the MG - 8.6±2.8X10 9/l, in the CG - 4.7+1.8X10 9/l
(p>0.05).
When evaluating biochemical blood tests, the
following indicators were significantly different:
43
43.5
44
44.5
45
45.5
46
46.5
ОГ, п=57
ГС, п=63
46.1
44.3
hematocrit index(%)
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AGES
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Cholesterol mmol/l, Bilirubin mmol/l, ALT IU/l, AST IU/l,
Prothrombin μmol/l, Glucose mmol/l.
Table 2
Blood biochemistry parameters
Indicators
MG, n=57
CG, n=63
p<
Cholesterol mmol/l
6,6±1,4
5,2±1,3
0,05
Bilirubin mmol/l
14,0±2,6
10,3+6,7
0,05
ALT IU/L
32,1 ±24,9
23,9+19,1
0,005
AST IU/L
31,6±29,1
19,5±9,0
0,005
Prothrombin µmol/l
79,7±42,1
73,2±10,2
0,05
Glucose mmol/l.
7,4±1,9
5,6±0,5
0,05
Creatinine mmol/l
0,08±0,01
0,07±0,003
In the MG, the values of these indicators were 6.6±1.4,
14.0±2.6, 32.1±24.9, 31.6±29, 179.7±42.1, 7.4±1.9 versus
5.2±1.3, 10.3+6.7, 23.9+19.1, 19.5±9.0, 73.2±10.2, 5.6±0.5
in the CG, respectively. There were no significant
differences in the values of Creatinine mmol/l between
the groups (Table 2).
Table 3.
Blood acid-base balance indicators
Acid-base balance
indicators
MG, n=57
CG, n=63
p<
PO 2 mmHg
57,4 ±7,5
69,9 ± 8,3
0,01
RSO 2 mmHg
48,1 ± 10,6
42,8 ± 6,9
0,05
AB mmol/l.
5,3 ± 3,4
6,1 ±9,5
0,05
HCO3 mmol/l.
31,4 ±4,1
28,5 ± 3,7
0,05
Note: bicarbonate (HCO
3
), partial pressure of oxygen (Pо
2
), AB (mmol/l) — true bicarbonates of the blood
(actual bikarbonate);
Volume 04 Issue 10-2024
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International Journal of Medical Sciences And Clinical Research
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VOLUME
04
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AGES
:
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OCLC
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Patients in the MG had significantly lower levels of
partial pressure of oxygen and oxygen saturation in the
morning hours (significantly lower levels of PO2 (p =
0.01), as well as higher levels of PCO2 in the morning
hours) (Table 3.).
The blood gas composition in the MG, the pO2 level
was 57.4 ± 7.5 mm Hg, in the CG, the pO2 level was 69.9
± 8.3 mm Hg. Thus, patients with CCI with concomitant
COPD had a significantly lower PO2 level (p = 0.01), as
well as a higher PCO2 level in the morning hours.
CONCLUSION
Patients in the MG had significantly lower levels of
partial pressure of oxygen and oxygen saturation in the
morning hours (significantly lower levels of PO2 (p =
0.01), as well as higher levels of PCO2 in the morning
hours)
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Suslina Z.A., Varakin Yu.Ya., Vereshchagin N.V.
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Shumatov
V.B.,
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