CLINICAL , FUNCTIONAL AND MORPHOLOGICAL CHARACTERISTICS OF BRAIN VESSELS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

To study the clinical, functional and morphological state of cerebral arteries in chronic obstructive pulmonary disease (COPD) at different stages of chronic pulmonary heart (HPH) 83 patients were examined. The first group included 25 patients with COPD and no pulmonary hypertension. The second group consisted of 33 patients with COPD complicated by compensated HPH. The third group included 25 patients with COPD and decompensated HPH. An autopsy material of 46 patients with COPD was investigated. It was established that the functional and morphological changes in brain arteries develop in early stages of COPD. Its severity depends on disease progression and HPH development. In group 1 the thickness of intima-media of the common carotid artery didn't differ from that of the control group, in the 2nd and 3rd groups it increased to 0.98±0.02 mm (p<0.05) and 1.14±0.05 mm (p<0.01), respectively. In patients of Group 1 there was an increase of resistive and pulsation index in the internal carotid arteries to 0.84±0.12 (p<0.01) and 1.97±0.18 (p<0.05), respectively, and in middle cerebral arteries to 0.57±0.05 (p<0.05) and 0.94±0.13 (p<0.05), respectively. The patients of Group 2 were characterized by maximum deceleration of blood flow velocity in middle cerebral artery to 86.4±4.45 cm/s (p<0.05). The patients of Group 3 showed a further decrease in blood flow velocity in intracranial arteries (p<0.01) and the maximum deceleration of blood flow velocity in the extracranial arteries to 39.16±3.28 cm/s (p<0.01). The results of morphological study of patients who died of COPD showed an increase in thickness of the intima-media complex in the Group 1 to 4.5%, in the Group 2 to 18%, in the Group 3 to 33% compared with controls. These changes can significantly limit the adaptive capacity of the vascular system of the brain, develop the progression of encephalopathy, which significantly reduces the quality of life, worsens the prognosis and dictates the need for correction therapy.

chronic obstructive pulmonary disease, chronic pulmonary heart, brain arteries, brain hemodynamics

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