Резюме
Володкіна Н.О. Реологічні властивості сироватки крові при хронічному обструктивному захворюванні легенів у шахтарів-вугільників.
В порівнянні із здоровими шахтарями, у хворих на хронічне обструктивне захворювання легенів вище показники міжфазної активності сироватки крові. На реологічний стан даної біологічної рідини мають свій вплив вік пацієнтів та підземний стаж роботи. Поверхневий натяг крові відображає виразність легеневої гіпертензії, а релаксація сироватки – рівень легеневого судинного опору. Має місце вплив гірничо-геологічних чинників на реологічний стан крові хворих шахтарів.
Ключові слова: хронічне обструктивне захворювання легенів, шахтарі, кров, сироватка, реологія.

Резюме
Володкина Н.А. Реологические свойства сыворотки крови при хроническом обструктивном заболевании легких у шахтеров-угольщиков.
По сравнению со здоровыми шахтерами, у больных хроническим обструктивным заболеванием легких выше показатели межфазной активности сыворотки крови. На реологическое состояние данной биологической жидкости оказывают свое влияние возраст пациентов и подземный стаж работы. Поверхностное натяжение крови отражает выраженность легочной гипертензии, а релаксация сыворотки – уровень легочного сосудистого сопротивления. Имеет место влияние горногеологических факторов на реологическое состояние крови больных шахтеров.
Ключевые слова: хроническое обструктивное заболевание легких, шахтеры, кровь, адсорбция, реология.

Summary
Volodkina N.A. Rheological properties of blood serum at coal miners with chronic obstructive pulmonary disease.
At patients with chronic obstructive pulmonary disease (COPD) rates of interfacial activity of serum are higher compared with healthy miners. Patients’ age and length of service underground exert their influence to the rheological state of the biological fluid. The surface tension of the blood reflects the severity of pulmonary hypertension, and the relaxation of the serum - the level of pulmonary vascular resistance. There are mining and geological factors influence the rheological state of sick miners  blood.
Key words: chronic obstructive pulmonary disease, miners, blood, adsorption, rheology.  

Рецензент: д.мед.н., проф. Л.М. Іванова

УДК 616.233+616.15-073.462.9+532.135

Донецький національний медичний університет ім. М. Горького

Донецкий национальный медицинский университет им. М.Горького

M. Gorky Donetsk National Medical University

natali.volod@yandex.ua

The problem of chronic obstructive pulmonary disease (COPD) occupies one of the leading places in clinical medicine, that is caused by considerable general increasing of morbidity rate. The purpose and tasks of this work is estimation of rheological properties of blood serum (RPBS) for coal miners and workers of  non-miner's professions, suffering from COPD, and also for healthy miners. 98 men with COPD were under supervision, that were divided into two groups. The 1st (control) group consisted of 41 (38,0%) men – the representatives of non-miner's professions (metallurgists, coke chemists, mechanicians), the 2nd (basic) one consisted of 57 (52,8%) coal miners. Breakage face miners made 42,1% of number of miners, shaft miners made 22,8%, underground miners made 21,1%, operators of rock removing machines made  10,5%, underground wiremen made 3,5%.

The age of non-miners was from 31 to 53 years (on the average 42,7±0,93 years), and the age of coalliery miners  was from 35-60 years (47,1±0,99 years, p=0,002). The underground experience of miners was 10-38 years (24,4±0,99 years). Duration of COPD for miners was 7-28 years (14,4±0,65 years), and  heavy form of disease was established in 47,4% cases. One more control group was consisted of 16 practically healthy miners, that did not differ from the basic group by age and underground experience.

Patients had spirography and pneumotachography, electrocardiography  and echocardiography.  Interphase tensiometry of blood serum was executed by means of analysis of the axisymmetric drops’ form .

Results and discussion

Miners with COPD have reliable increase on 31,0%m, on 45,2% - e, in 2,2 times – t in comparison with healthy miners. Thus there is reduction of l tensiogram on 21,1%. Comparing the got results with the character of changes of interphase tensiograms for the non-miners patients, common at COPD is the increase m, e and t of blood. In the group of sick miners the characteristics s (p=0,005) appeared to be on 4,3%, but on 44,8% lower than l  (p<0,001). More meaningful physical and chemical characteristics of blood for non-miners concerned interphase activity. It appeared, that  s  straight correlates with the level of immunoglobulin-M and phospholipids, but  it depends inversely  on maintenance of immunoglobulin-G, circulatory immune complexes, b₂-microglobulin, general cholesterol, lipoproteins of high, low and very low density. Interphase surface activity straight depends on concentration in blood of total protein, albumins and lipoproteins of high-density, but it is inversely related to the level of b₂-microglobulin, cholesterol, triglycerides, lipoproteins of low and very low density. The age of sick miners (p<0,001), their underground experience of work (p=0,006),  presence of obstruction and restriction at  spirography at the moment of examination (accordingly p<0,001), but not duration of disease influence on RPBS. The restrictive type of abnormalities of the external breathing influences on interphase activity, although correlation relationship of this physical and chemical characteristic with severity of spirographic dislocation are absent.

The indexes of forced vital lung capacity inversely correlates with m, systole pressure in the pulmonary artery correlates with s and l, pulmonary vascular resistance correlates with t. We consider that decrease of s and t of blood accordingly less than 45 mN/m and 160 sec (<M-3m sick miners) belongs to the negative features of COPD progression  for coal miners.

Conclusions

The age of miners and their underground experience of work influence on RPBS for the patients with COPD. The restrictive type of the external breathing function influences on the interphase surface activity, that reflects intensity of pulmonary hypertension, and relaxation state of serum reflects the level of pulmonary vascular resistance. There is influence of mining and geologic factors on RPBS of miners with COPD.

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