LEVELS OF MEDIUM- AND LOW-MOLECULAR-WEIGHT SUBSTANCES AND OLIGOPEPTIDES IN PATIENTS WITH MYOCARDIAL INFARCTION AGAINST CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH SINGLE- AND MULTIVESSEL CORONARY ARTERY DISEASE
The presence of endogenous intoxication syndrome in somatic pathology worsens the course and prognosis of diseases. It is especially urgent to study this syndrome in comorbid pathology, in particular, in myocardial infarction development in patients with chronic obstructive pulmonary disease. The objective markers of endogenous intoxication are medium and low molecular weight substances and oligopeptides. Aim. The aim is to estimate the severity of endogenous intoxication syndrome by studying the levels of medium and low molecular weight substances and oligopeptides in patients with myocardial infarction developed against the background of chronic obstructive pulmonary disease depending on the number of coronary arteries affected. Material and methods. 225 patients with myocardial infarction were examined. In 130 of them the infarction developed as monosomal disease, and in 195 - against the background of previously documented chronic obstructive pulmonary disease. Among patients with myocardial infarction as monoinflammation, 71 (64.5%) had a single-vessel lesion and 59 (35.5%) had a multivessel lesion. Among patients with myocardial infarction against chronic obstructive pulmonary disease, lesion of the 1st coronary artery was found in 50 patients (25.6%), and multivessel lesion was found in 145 (74.4%). The comparison group included 110 somatically healthy subjects. We used direct spectrometry (according to M.Y. Malakhova, 1995) to determine the levels of medium and low molecular weight substances and oligopeptides. Statistical data processing was carried out using software package SPSS 26.0. Results and discussion. In the group of patients with myocardial infarction the levels of medium and low molecular weight substances and oligopeptides and calculated indices showed significant differences in single- and multivessel lesions. In the 1st coronary artery lesion, the indices in most cases were comparable with the values in the control group. In the group of myocardial infarction patients with multivessel lesions, the values of medium and low molecular weight substances and oligopeptides increased significantly. In patients with myocardial infarction against the background of chronic obstructive pulmonary disease, all intoxication parameters were significantly higher compared not only with the control, but also with patients with myocardial infarction as monoinflammation. However, the values in the subgroups with single and multivessel lesions did not demonstrate statistical reliability. Conclusion. The number of affected vessels, and hence the volume of ischemic myocardium, affects the severity of endogenous intoxication in patients with myocardial infarction as mononasal. In this case, the elimination function of the excretory organs is not impaired, which means that the level of intoxication is due to the production of toxins in conditions of ischemia and myocardial necrosis. In conditions of cardiorespiratory comorbidity chronic obstructive pulmonary disease contributes significantly to the development of endogenous intoxication, aggravating it and levelling the differences occurring in monosensing.