CHRONIC PANCREATITIS AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE: CLINICAL ASPECTS OF COMORBIDITY

Abstract

Objective: To identify chronic obstructive pulmonary disease (COPD) features of the clinical manifestations in patients with chronic pancreatitis (CP). Materials and methods. 67 patients with comorbidity of CP and COPD (main group), 54 - with isolated COPD (compared group) have been examined. Assessment of clinical symptoms severity was perfomed by Modified Medical Research Council (mMRC) Dyspnea Scale and a 4-point scale of COPD patients symptoms (P. L. Paggiaro). Integral assessment of the impact of COPD on patient was conducted in accordance with the GOLD guidelines (2015). Results. It has been found out that patients with comorbid pathology are characterized by the significant increase rate of infectious exacerbation of COPD than in the compared group: 67.2% vs. 48.1% (p = 0.03). The seasonal nature of COPD exacerbation was observed in isolated COPD in 88.9% of cases, in comorbid pathology - 73.1% (p = 0.03). In compared group 1,4 ± 0,2 exacerbations per year were recorded, in patients of the main group - 2,3 ± 0,4 (p = 0.03). Severity of dyspnea in patients of the main group was 2,4 ± 0,5 points, in compared group - 2,1 ± 0,6 points (p = 0.03). The expressiveness of cough in isolated COPD made up to 2,3 ± 0,4 points, while comorbid disease - 2,6 ± 0,5 points (p = 0.03). Intensity of sputum in patients of the main group reached 1,7 ± 0,6 points, in compared group 1,6 ± 0,7 points (p = 0.66). Integral assessment of the COPD impact on patient (GOLD, 2015) showed that the distribution of patients with comorbid pathology by groups of risk had a significant difference from the one in the compared group (df = 2, χ2 = 14,201, p < 0.001). Conclusions. The presence of concomitant chronic pancreatitis in patients with COPD brings in a certain deviation in the clinical characteristics of the disease: significantly more often as a trigger were acute respiratory viral infections, less pronounced seasonal nature of exacerbations, significantly increasing the number of exacerbations per year, a significant increase of dyspnea, cough and changes of sputum. Carrying out the integrated assessment of the impact of COPD on patient it has been observed that redistribution of main group patients into risk groups in the side of its aggravation.