Clinical releveance of hemorrhagic component of endobronchial inflammation in severe chronic obstructive pulmonary disease exacerbation


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Abstract

Aim. The study aimed at investigating the relationship between severe exacerbations of chronic obstructive pulmonary disease and hemorrhagic component of endobronchial inflammation. Materials and methods. Clinico-endoscopic characteristics of 118 patients presenting with severe infectious exacerbation of chronic obstructive pulmonary disease, bloody expectorations and endoscopically confirmed hemorrhagic component of endobronchial inflammation have been analyzed. All patients underwent a series (5-6) of bronchoscopic examinations accompanied by collection of bronchoalveolar lavage specimens to reveal the presence of acid-resistant mycobacteria and to determine the bacterial flora. The exclusion criteria were the concomitant pulmonary or extrapulmonary pathologic conditions which could lead to hemorrhagic endobronchial manifestations. The other direction of the study was to investigate a correlation between jugulation of the exacerbation and dynamics of such endobronchial symptoms as mucosal edema and hyperemia, quality of bronchial secretions and hemorrhagic component of endobronchial inflammation. Results. All patients were found to have diffuse endobronchitis of severity grade II (39.83%) or III (60.17%) by Lemoine. The neoplastic and tuberculosis genesis of the hemorrhagic component of endobronchial inflammation and its clinical equivalent, the bloody expectorations, had been ruled out. In 50.85% of cases the hemorrhagic component of endobronchial inflammation could not be accounted for by hemolytic properties of cultured microorganisms. The mucosal edema and hyperemia remained stable during jugulation of the exacerbation. Unlike the improvement of quality of bronchial secretions, faster reversal of the hemorrhagic component of endobronchial inflammation showed statistical significance. Conclusion. The hemorrhagic component of endobronchial inflammation can represent a non-obligatory manifestation of severe exacerbation of chronic obstructive pulmonary disease, and its relief is the earliest endobronchial sign of incipient remission from severe COPD exacerbation.

About the authors

M L Shteiner

Samara City Hospital №4; Samara State Medical University of the Ministry of Health of the Russian Federation

Email: iishte@yandex.ru
врач-эндоскопист ГБУЗ Самарской области «Самарская городская больница №4»; д.м.н., доцент каф. хирургии c курсом эндоскопии института профессионального образования Samara, Russia

A V Zhestkov

Samara State Medical University of the Ministry of Health of the Russian Federation

д.м.н., проф., зав. каф. общей и клинической микробиологии, иммунологии и аллергологии; ORCID: 0000-0002-3960-830X Samara, Russia

S A Babanov

Samara State Medical University of the Ministry of Health of the Russian Federation

д.м.н., проф., зав. каф. профессиональной патологии и клинической фармакологии; ORCID: 0000-0002-1667-737X Samara, Russia

Iu I Biktagirov

Samara State Medical University of the Ministry of Health of the Russian Federation

к.м.н., зав. курсом эндоскопии, доцент каф. хирургии института профессионального образования; ORCID: 0000-0002-3949-2714 Samara, Russia

A D Protasov

Samara State Medical University of the Ministry of Health of the Russian Federation

к.м.н., доцент каф. общей и клинической микробиологии, иммунологии и аллергологии; ORCID: 0000-0001-8452-5776 Samara, Russia

V V Kulagina

Samara Medical University “Reaviz”

к.м.н., доцент каф. клинической медицины; ORCID: 0000-0002-8824-0046 Samara, Russia

D S Budash

Samara State Medical University of the Ministry of Health of the Russian Federation

к.м.н., ассистент каф. профессиональной патологии и клинической фармакологии; ORCID: 0000-0003-2967-8264 Samara, Russia

M O Zolotov

Samara State Medical University of the Ministry of Health of the Russian Federation

ординатор каф. общей и клинической микробиологии, иммунологии и аллергологии ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России; ORCID: 0000-0002-4806-050X Samara, Russia

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