THE USE OF STATINS FOR THE TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND TYPE 2 DIABETES

Abstract

Relevancy. The combination of chronic obstructive pulmonary disease and type 2 diabetes is studied insufficiently. The incomplete treatment regimen hinders the solution to this problem by including statins in the complex treatment of patients with chronic obstructive pulmonary disease combined with type 2 diabetes mellitus. Objective: to evaluate the effectiveness of including statins in the complex treatment of patients with chronic obstructive pulmonary disease secondary to type 2 diabetes mellitus. Materials and methods. Examination of patients with chronic obstructive pulmonary disease (COPD), including 64 patients with concomitant type 2 diabetes, was conducted on the basis of the pulmonology department of the Chernivtsi Regional Clinical Hospital in 2016-2020. Patients were divided into two groups – the main and the control. Patients with COPD with concomitant type 2 diabetes in the main group (49 patients) were prescribed atorvastatin at a dose of 20-40 mg once a day. The control group (15 COPD patients with concomitant type 2 diabetes) received essential treatment without atorvastatin. Patients received basic therapy depending on the group of patients (A, B, C and D) and the prevalence of shortness of breath or the frequency of exacerbations, long-acting bronchodilators (long-acting β2-agonists and/or long-acting anticholinergic drugs). A separate group of patients received a combination of a long-acting β2-agonist with an inhaled glucocorticosteroid. Some patients were prescribed roflumilast and antibactereal drugs from the group of macrolides (azithromycin or erythromycin). In the presence of sputum, patients were prescribed mucolytic drugs (Lazolvan, ACC, carbocisteine, erdosteine). In case of exacerbation, patients received a short course glucocorticosteroids parenterally, antibacterial drugs (for infectious exacerbation), nebulizer therapy.               The effectiveness of therapy was evaluated after six months of treatment using the following diagnostic methods: clinical data (dyspnea, cough, sputum production - according to the BCSS scale; and shortness of breath, cough, sputum production and its color - according to the Paggiaro scale), the number of hospitalizations per year, the number emergency medical calls.               Mathematical processing of the obtained data was carried out using programs BioStat 2009 Professional, version 5.8.4.3 (AnalystSoft Inc.), SPSS (Statistical Package for Social Science Statistics) 16.0, Statistisa 10.0 StatSoft Inc., Microsoft Excel 2010. Before testing statistical hypotheses were determined coefficients of asymmetry and kurtosis using the Hahn-Shapiro-Wilkie test to analyze the normality of the distribution of values ​​in randomized samples. Results. When analyzing clinical data in treatment dynamics with atorvastatin, it was found that according to the BCSS, shortness of breath in patients of the main group significantly decreased. Cough in COPD patients with concomitant type 2 diabetes treated with atorvastatin decreased by 25.3% at the end of treatment. A decrease in sputum production was observed in two groups of patients, and the changes were significant. Reduction of the frequency of exacerbations per year, the number of emergency calls, and the number of hospitalizations per year in the dynamics of atorvastatin treatment were also observed in COPD patients with concomitant type 2 diabetes. Conclusion. the use of atorvastatin in the complex treatment of COPD patients with concomitant type 2 diabetes resulted in a decrease in the frequency of exacerbations per year, the number of emergency calls, and the number of hospital admissions per year.