~ 74 ~ The Pharma Innovation Journal 2018; 7(1): 74-78 ISSN (E): 2277- 7695 ISSN (P): 2349-8242 NAAS Rating: 5.03 TPI 2018; 7(1): 74-78 © 2018 TPI www.thepharmajournal.com Received: 11-11-2017 Accepted: 12-12-2017 Yuriy Feschenko National Institute of Phthysiology and Pulmonology Named After F.G. Lanovskyi NAMS, Ukraine Liudmyla Iashyna National Institute of Phthysiology and Pulmonology Named After F.G. Lanovskyi NAMS, Ukraine Ksenia Nazarenko National Institute of Phthysiology and Pulmonology Named After F.G. Lanovskyi NAMS, Ukraine Svitlana Opimakh National Institute of Phthysiology and Pulmonology Named After F.G. Lanovskyi NAMS, Ukraine Correspondence Ksenia Nazarenko National Institute of Phthysiology and Pulmonology Named After F.G. Lanovskyi NAMS, Ukraine Factors of formation of small airways obstruction and lung hyperinflation in patients with combined pathology of asthma and chronic obstructive pulmonary disease Yuriy Feschenko, Liudmyla Iashyna, Ksenia Nazarenko and Svitlana Opimakh Abstract The most unfavorable variants of combined lung obstructive pathology are small airways obstruction and lung hyperinflation. The aim of this work was to study the factors of the formation of small airways obstruction and lung hyperinflation in patients with combined pathology of asthma and COPD. Severe violations of the lung function parameters in the form of small airways obstruction and pulmonary hyperinflation may exist simultaneously. The common factors of these complications are the elderly age of patients, bronchial obstruction, decreased exercise tolerance, severe dyspnea and high BODE index. The differences in risk factors are the dependence of small bronchial obstruction on the type of local bronchial inflammation and the disease from which the ACO debuted, while lungs hyperinflation depends on the factors of the general low health status and the decrease in the predicted life expectancy of the patients. Among the concomitant cardiovascular pathologies, arterial hypertension and the presence of left ventricular hypertrophy, along with obesity, have a greater effect on the obstruction of the distal respiratory tract, and ischemic heart disease - on lung hyperinflation. Pulmonary hypertension is a factor in the occurrence of both complications. Keywords: Asthma-COPD overlap, small airways obstruction, lung hyperinflation Introduction The combination of asthma and chronic obstructive pulmonary disease (asthma-COPD overlap (ACO)) in one patient is an actual problem in pulmonology [1] . An interesting question is the pathophysiology of violations of the lung function parameters in ACO patients, and the choice of adequate therapy for these patients. The most unfavorable variants of these disorders are small airways obstruction and lung hyperinflation [2] . Factors contributing to the formation of these states are numerous and go beyond purely pulmonary pathology. According to literature, it is known that increased airiness of lung tissue on the one hand is more common in patients with concomitant cardiovascular pathology. On the other hand, lung hyperinflation promotes hemodynamic disorders by breaking the venous return and reducing the right ventricle preload, and large intrathoracic pressure causes left ventricular dysfunction [3] . There is also evidence that the formation of lung emphysema is associated with the neutrophilic type of bronchial inflammation [4] . The aim of this work was to study the factors of the formation of small airways obstruction and lung hyperinflation in patients with combined pathology of asthma and COPD. Materials and Methods The study included patients with ACO (n = 140) of an average age of 58.56 ± 0.81 years undergoing baseline therapy, but there were pronounced symptoms and impaired lung function. Diagnosis of ACO was exposed according to the criteria given in the main international guidelines for the management of asthma and COPD patients - GINA and GOLD [8, 9] . All patients had persistent, but variable symptoms characteristic of asthma and COPD, the state of patients was stable, no exacerbation 2 months before the study. The average forced expiratory volume for the first second (FEV1) of patients was (59.0 ± 1.4)% and the ratio of FEV1 to forced vital capacity (FVC) - FEV1 / FVC - (53.6 ± 0.8)%. In 91 patients, the disease debuted with asthma, in 49 other cases, a COPD was initially diagnosed.