[Computed tomography in the assessment of causes of restrictive lung disorders in patients with pulmonary histiocytosis X].

OBJECTIVE: To estimate the capabilities of computed tomography (CT) in revealing the anatomic causes of restrictive lung changes in patients with pulmonary histiocytosis X. SUBJECT AND METHODS: The results of examining 36 patients with pulmonary histiocytosis X, who underwent comprehensive functional study of external respiration (CRSER), CT, and high-performance CT (HPCT), were analyzed. RESULTS: According to the results of CRSER, the authors identified a group of patients with restrictive ventilation disorders, which included 7 men and 1 woman. The most common cause of restrictive disorders was generalized fibrous changes in lung tissue, which fails to result in its expansion. Multiple cysts were another cause of restrictive disorders in 2 patients. Fusion of individual cysts into large ones and the formation of a great number of paradoxically ventilated cysts were the third cause of restrictive disorders in pulmonary histiocytosis X, which was identified during HPCT. CONCLUSION: Comprehensive morphofunctional examination involving CRSER and high-resolution CT can reveal the unfavorable course of pulmonary histiocytosis X with the restrictive type of lesion.

[Combination of thiotropium bromide with almitrine and pulmonary rehabilitation in the treatment of patients with chronic obstructive pulmonary disease].

AIM: To elucidate efficacy of a combination almitrine+thiotropium bromide (TB)+pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) of stage II-III complicated with chronic respiratory failure (CRF). MATERIAL AND METHODS: Efficacy of therapy was compared in two groups of patients: group 1 (n = 22) received TB in a dose 18 mcg/day for one year, almitrine in a dose 10 mg/kg/day for 3 months, an 8 week course of PR, group 2 (n = 17) received TB and PR. The treatment efficacy was determined by spirometric parameters of external respiration function, blood gases, dyspnea indices, exercise tolerance assessed by 6-min walk test, quality of life (St. George Hospital Respiratory Questionnaire). RESULTS: Group 1 patients walked longer distance after a course of PR and 1 year later (by 90.5 +/- 25.4 and 44.5 +/- 10.2 m, respectively, p < 0.05), had reduced desaturation measured by pulsoxym-etry at the end of 6-min walk test, increased PaO2 in baseline under 70 mmHg (by 5.8 +/- 1.2 mmHg, p > 0.05), decreased exacerbation rate per 1 patient a year (by 25%). CONCLUSION: Combination treatment with TB, almitrine and PR is indicated for COPD patients with moderate hypoxemia.