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  • Title: СHRONIC OBSTRUCTIVE PULMONARY DISEASE IN THE CLEAN-UP WORKERS OF CHORNOBYL NPP ACCIDENT IN A REMOTE POST6ACCIDENT PERIOD (CLINICAL STUDY).
    Author: Shvaiko LI, Bazyka KD, Sushko VO, Masyuk SV.
    Journal: Probl Radiac Med Radiobiol; 2018 Dec; 23():490-498. PubMed ID: 30582866.
    Abstract:
    OBJECTIVE: to study the clinical differences in the course of chronic obstructive pulmonary disease in the clean-upworkers (CW) of Chornobyl nuclear power plant (ChNPP) in the remote post-accident period (30 years after the effectof radiation exposure). MATERIAL AND METHODS: 120 CW of ChNPP were examined (47 patients with chronic obstructive pulmonary disease(COPD) and 73 patients without bronchopulmonary disease) and 50 patients in the control group (20 patients with COPDand 30 without bronchopulmonary disease). Individually documented radiation exposure doses of CW were (25.2 ± 13.7cSv, (M ± SD)). The study program included clinical examination, functional pulmonary tests, and statistical analysis. RESULTS: The negative correlation dependence (r = -0,358, p < 0,05) between the 6-minute walk rate and the age ofCOPD patients was established. Negative correlation was observed between the distance at 6-minute walk test, andforced exhalation volume for 1 sec. (FEV1) (l) (r = 0.743; p < 0.05); forced vital capacity (FVC) (l) (r = 0.692;p < 0.05), the ratio of FEV1/FEV6 (r = 0.697; p < 0.05), forced exhalation volume for 6 sec (FEV6) (l) (r = 0.727; p < 0.05),Diffusion Lung Capacity (mmol/min/kPa) (r = 0.754, p <0, 05). A positive correlation was found between the dose ofradiation exposure and the index of intra-thoracic pressure (ITGV) in the CW (r = 0.1494, p <0.05), and the values ofFEV1 and forced expiration flow (FEF75), regardless of the presence of COPD. In the subgroup of patients with COPDCW there was a significantly higher proportion of patients with cardiovascular and cerebrovascular pathology, whichcorresponded with the higher level of cholesterol compared with the control group ((5.52 ± 1.34) mmol/l and(4.46 ± 1.74) mmol/l, respectively, p < 0.05). CONCLUSIONS: In the CW at the ChNPP, compared with the group of nosological control, there were significantly lowerindicators of the shortness of breath degree and the frequency of exacerbations per year, more pronounced distur-bance of exercise tolerance, higher comorbidity. Dependence of development of COPD on radiation dose and age atthis stage of research was not estimated. Meta: vyvchyty klinichni vidminnosti perebigu khronichnogo obstruktyvnogo zakhvoriuvannia legen' v uchasnykivlikvidatsiï naslidkiv avariï (ULNA) na ChAES u viddalenomu pisliaavariĭnomu periodi (30 rokiv pislia diï radia-tsiĭnogo oprominennia)Materialy ta metody. Obstezheno 120 ULNA na ChAES (47 patsiientiv iz khronichnym obstruktyvnym zakhvoriuvanniamlegen' (KhOZL) i 73 – bez zakhvoriuvan' bronkholegenevoï systemy) ta 50 osib kontrol'noï grupy (20 patsiientiv izKhOZL ta 30 – bez zakhvoriuvan' bronkholegenevoï systemy). Indyvidual'ni dokumentovani dozy radiatsiĭnogo op-rominennia uchasnykiv LNA na ChAES stanovyly (25,2 -#177; 13,7 sZv, (M-#177;SD)). V programu doslidzhennia vkhodylyklinichne obstezhennia, funktsional'ni legenevi testy, statystychnyĭ analiz.Rezul'taty. Vstanovleno negatyvnu koreliatsiĭnu zalezhnist' (r = -0,358, r -#060; 0,05) mizh pokaznykom 6 khvylynnoïkhody ta vikom khvorykh na KhOZL patsiientiv. Negatyvnyĭ koreliatsiĭnyĭ zv’iazok sposterigavsia mizh dystantsiieiu, iakuprokhodyly patsiienty pid chas 6 khvylynnoï khody, ta ob’iemom forsovanogo vydykhu za 1 s (OFV1) (l) (r = 0,743;r -#060; 0,05), forsovanoiu zhyttievoiu iemnistiu legen' (FZhEL) (l) (r = 0,692; r -#060; 0,05), ob’iemom forsovanogo vydykhuza 6 s OFV6 (l) (r = 0,727; r -#060; 0,05), spivvidnoshennia OFV1/OFV6 (r = 0,697; r -#060; 0,05), dyfuziĭnoiu zdatnistiu le-gen' (mmol'/khv/kPa) (r = 0,754; r -#060; 0,05). Pozytyvna koreliatsiia vyiavlena mizh dozoiu radiatsiĭnogo oprominenniata pokaznykom vnutrishn'o-grudnogo tysku (VGT) v ULNA (r = 0,1449, p -#060; 0,05), ta pokaznykamy OFV1 ta maksymal'-noiu shvydkistiu vydykhu na rivni 75 % (MOSh75), nezalezhno vid naiavnosti KhOZL. U pidgrupi khvorykh na KhOZL ULNAsposterigalas' dostovirno vyshcha chastka khvorykh na sertsevo-sudynnu ta tserebrovaskuliarnu patologiiu, kotriĭ ko-responduvav vyshchyĭ riven' kholesterynu, porivniano iz kontrol'noiu grupoiu ((5,52-#177;1,34) mmol'/l ta (4,46-#177;1,74)mmol'/l, vidpovidno, r -#060; 0,05).Vysnovky. Perebig KhOZL v uchasnykiv LNA na ChAES u viddalenomu pisliaavariĭnomu periodi vidznachavsia dos-tovirno nyzhchymy pokaznykamy stupenia zadyshky ta chastoty zagostren' na rik, vyraznishymy porushenniamy tole-rantnosti do fizychnogo navantazhennia, shcho uzgodzhuvalos' z vyshchym rivnem komorbidnosti. Vstanovyty zalezhnist'rozvytku KhOZL vid dozy oprominennia ta viku na danomu etapi doslidzhen' ne vdalosia.
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