[Types of structural-functional disorders in severe chronic obstructive pulmonary disease]

To differentiate approaches to assessment of treatment and prognosis specificities in a severe course of chronic obstructive pulmonary diseases (COPD), a study was made of 30 patients with long-term COPD. The patients were divided into groups by the severity of respiratory insufficiency which was investigated by saturation of 0(2) and gas composition of arterialized capillary blood, flow-volume curve and bodyplethysmography, ECG, echo-CG. High resolution computed tomography of the lungs was used to evaluate diffuse changes of pulmonary tissue and its morphological rearrangement. Basing on the rhoentgenomorphological picture, most typical variants of pulmonary tissue changes were identified. Comparison with the clinical and laboratory-instrumental data allowed to characterize four structural-functional types which occur in severe COPD. Etiological and pathogenetic features of the above types (the role of smoking, in particular) and their contribution to development of pulmonary hypertension, treatment and prognosis are discussed.