| Abstract | Cilj istraživanja: Kronična opstruktivna plućna bolest multisistemska je bolest, jedan od vodećih uzroka mortaliteta i morbiditeta u svijetu. Cilj je ovog istraživanja procijenti razinu biljega endotelne disfunkcije vWF-a i izdisajnog dušikova oksida (NO) kod oboljelih od KOPB-a te usporediti njihovu razinu ovisno o stupnju težine KOPB-a. Nacrt studije: Radi se o presječnom istraživanju koje uključuje tri skupine ispitanika: (1) skupinu oboljelih od KOPB-a, bez pridruženog komorbiditeta, (2) kontrolnu skupinu pušača, bez pridruženog komorbiditeta, (3) kontrolnu skupinu nepušača, bez pridruženog komorbiditeta Ispitanici i metode: U istraživanje je uključeno ukupno 100 ispitanika, 60 oboljelih od KOPB-a bez pridruženog kardiovaskularnog komorbiditeta, a 40 ispitanika predstavlja kontrolne skupine. Ispitanici su učinili FeNO-test, spirometrijsko testiranje imjerenje difuzijskog kapaciteta za CO. Uzeti su im uzorci venske krvi za analizu razine vWf-a (metodom vWF:RCO), C-reaktivnog proteina (CRP), fibrinogena, kolesterola, triglicerida te je provedena analiza acidobaznog statusa. Oboljeli od KOPB-a potom su ispunili odgovarajuće upitnike - CAT-test i mMRC. Rezultati: Istraživanje je pokazalo da je u skupini oboljelih odnos između vWf-a i izdisajnog NO-a negativan, što znači da su više vrijednosti vWf-a povezane s nižim vrijednostima izdisajnog NO-a. Usporedbom oboljelih ovisno težini KOPB-a nije utvrđena razlika u razini vWf-a [F (3, 56) = 0,24,p =,869], dok je, iako ne statistički značajna, najviša razina izdisajnog NO-a utvrđena u skupini A, a najniža u skupini D. Porast vrijednosti vWf -a praćen je porastom vrijednosti fibrinogena, još jednog biljega endotelne disfunkcije. Usporedbom aktualnih i bivših pušača unutar skupine oboljelih nije utvrđena statistički značajna razlika u razini ispitivanih biljega. Usporedbom oboljelih s kontrolnim skupinama nije utvrđena statistička razlika u razini vWf, dok je kontrolna skupina pušača imala statističke više vrijednosti izdisajnog NO. Kod oboljelih je utvrđena značajna, negativna, povezanost vWf-a s vrijednošću indeksa tjelesne mase (BMI). Zaključak: Rezultati ovog istraživanja pokazali su da oboljeli u stabilnom stadiju KOPB-a, bez pridruženog kardiovaskularnog komorbiditeta nemaju biokemijske znakove endotelne disfunkcije, vWf-a i izdisajnog NO-a u odnosu na obje kontrolne skupine, pušača i nepušača |
| Abstract (english) | The aim of the research: Chronic obstructive pulmonary disease is a multisystemic disease, one of the leading causes of mortality and morbidity. The aim of this research is to assess the level of the markers of endothelial dysfunction, vWf (von Willenbrand factor), and the exhaled nitric oxide (NO) among the patients with COPD and compare their level depending on the severity of COPD. Study design: This is a cross-sectional research which includes three categories of subjects: (1) the group of patients with COPD without adjoining comorbidity, (2) the control group of smokers without adjoining comorbidity, (3) the control group of non-smokers without adjoining comorbidity. Materials and methods: One hundred participants were included in this research, sixty of which had COPD without adjoining cardiovascular comorbidity, and forty subjects belonged to the control group. The subjects took the FeNO test, underwent spirometry testing and the measuring of the diffusion capacity of CO, samples were taken of their vein blood to analyze the level of vWf (using the vWf:RCO method), C-reactive protein (CRP), fibrinogen, cholesterol, triglycerides as well as the acid base status. COPD patients then filled in the corresponding questionnaires, CAT test, mMRC. Results: The research has shown that in the ill-group the relation between vWf and exhaled NO was negative, which means that higher levels of vWf are associated with lower values of exhaled NO. By comparing the ill subjects depending of severity disease, a difference was established between the level of vWf [F (3, 56) = 0.24; p =.869], while, although statistically not significant, the highest level of exhaled NO was found in group A and the lowest in group D. The rise in the value of vWf is simultaneously followed by the rise of fibrinogen values, which is another marker of endothelial dysfunction. A comparison of current and former smokers in the group of ill subjects hasn’t show any statistically significant difference in the levels of the markers. By 58 comparing patients with control groups weren’t statistically difference in the level of vWf, while the control group of smokers had more statistical value exhaled NO. Within the ill ones a significant, negative association of vWf with the readings of body mass index (BMI) was found. Conclusion: The results of this research have shown that patients in stable stage COPD, without the associated cardiovascular comorbidities don’t have biochemical sings of endothelial dysfunction, vWf and exhaled NO in comparison to both control groups, smokers and non-smokers. |
