[Modern tendencies in co-morbid conditions]

The present manuscript reviews frequency of the concomitance of Ischaemic Heart Disease (IHD) with Chronic Obstructive Pulmonary Disease (COPD). The conclusion has been drawn, that quite a large group of patients (25.9%) suffers from pulmonary pathology concomitant with disorders of cardio-coronary system. 97 patients (84 male and 13 female) with concomitant IHD and COPD (steady cardiac angina FK II st.) have been admitted with acute pulmonary condition, and examined at the Department of Pulmonology at N.V. Sklifasovskiy Regional Teaching Hospital in Poltava. The patients were divided into 2 groups: patients in Group I (n=51) were receiving the basic therapy, according to the case management protocol for this type of disorders (β2-agonists, anticholinergic drugs, methylxantines, inhaler glucocorticoids, phosphodiesterase-4 inhibitors). Patients in the Group II (n=46), in addition to the basic protocol treatment were prescribed 4.2% L-Arginine (Tivortin) venous infusion therapy (100 ml QD for 6 days) with consequent change onto PO administration of 5-10 ml of the solution TID for 4 weeks. As a result, positive dynamics of regressing of clinical signs of COPD was apparent in both Groups after 10-12 days of the treatment. Clinical parameters, pulmonary, cardiac and indurance functions in patients of the Group II, who in addition to the basic treatment, were reciving L-Arginine were much better improved (p>0.05) than in Group I. The conducted study has allowed us to draw a conclusion, that including L-Arginine in the treatment protocol of COPD with concomitant IHD improves cardiohaemodynamics and allows for the better efficacy of respiratory pathology therapy. Addition of L-Arginine (Tivortin, "Yuriya-Farm", Kiev) to the complex therapy of COPD with concomitant IHD results in statistically significant improvement of clinical and instrumental test results, due to the drug's intihypoxic, antiagregational, membrane-stabilizing, antioxydant and vasodilating effect.