Aim. To study the relationship between parameters of cardiointervalometry and ergoreflex, and 6-minute walk test data in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods. The study included 103 men, of them 63 patients with COPD, 40 patients of the control group. Functional assessment of external respiration and a 6-minute walk test were performed using Spiropalm 6MWT equipment (Cosmed, Italy). The autonomic status and the influence of the ergoreflex on it were assessed by the method of cardiointervalometry before, during and after the test with external peripheral vascular occlusion using Varicard hardware and software complex (LLC Ramena, Ryazan, Russia). Results. When performing a 6-minute walk test, significant differences were obtained between the groups of patients with COPD and of the control group in the majority of the studied parameters (p0.01). In 18 of 63 patients with COPD, the level of SpO2 in 6-minute walk test decreased by 4% (p0.01). The obtained result is of considerable importance for assessment of exercise tolerance in patients with COPD. In tests with external peripheral vascular occlusion in patients with COPD and of the control group, the index of activity of regulatory systems (IARS) increased in both groups. However, after completion of the test, the index in patients with COPD decreased below the initial values (p0.05), and in patients of the control group the changes were even more pronounced (p0.01). Patients with COPD were divided into groups depending on the distance covered in 6-minute walk test. Analysis of the data revealed a moderate positive correlation between the covered distance and the forced expiratory volume in the 1st second (FEV1, R=0.45, p0.01).The maximum level of the total effect of the autonomic regulation of blood circulation was recorded in patients who covered the minimum distance (227.7748.13 m) in 6-minute walk test. Besides, a moderate negative correlation between IARS and the results of 6-minute test was recorded (R=-0.34, p0.01). Conclusions. 1. For assessment of the functional status of patients in 6-minute walk test it is important to take measurement of saturation throughout the whole test. 2. The change in IARS values in the test with external peripheral vascular occlusion can be regarded as a reduction of the influence of reflex from the lower limb ergoreceptors on the functional condition of patients. 3. Patients with COPD showed a marked autonomic imbalance. IARS showed a moderate negative correlation with the distance covered in 6-minute walk test. 4. Maximum value of IARS was obtained in patients with the minimal distance covered in 6-minute walk test.

Аim. Analysis of the possibility and reasonability of a comprehensive assessment of clinical condition of patients with chronic obstructive pulmonary disease (COPD) on outpatient visit in conditions of a small territorial municipal polyclinic. Materials and Methods. The study was carried out on the base of municipal Outpatient clinic №12 (total adult population 7177 people) of Ryazan from October 2012 to December 2014. In history taking, positive family history, existence of unfavorable factors that could provoke development and progress of the disease, coughing episodes in history, phase of the disease, medicinal treatment were evaluated. This was followed by a screening epidemiological examination (questionnaire). In result, an observation group was formed (n=50, aged 19-81 years, mean age 56.12.3 years) from patients with chronic respiratory symptoms (cough, dyspnea) seeking medical care, where screening spirography, evaluation of the degree of severity of COPD according to GOLD 2014 were conducted, and four observation groups (A, B, C, D) were formed. Results. COPD was confirmed in 100% of patients of the observation group, of them the 1st stage COPD was found in 18.7% of cases, 2nd in 43.3% of cases, 3rd in 30.0%, 4th in 8.0%. The number of exacerbations was 1-8 per year. The most common concomitant diseases were ischemic heart disease (53.2%), arterial hypertension (74.3%), chronic gastroduodenitis (34.5%). A combination of 2 or more chronic diseases was observed in 31% of cases. Depending on the degree of airflow rate limitation, symptoms (mMRC results), history of exacerbations, patients were divided into the following groups according to GOLD 2014: group A 59 patients (39.3%), group B 30 patients (20.0%), group C 29 patients (19.0%), and D 32 patients (21.7%). There were no statistically significant differences between the groups in age, gender and smoking status (p0.05). Conclusion. The analysis showed a possibility and convenience of using stratification of patients with COPD by the degree of severity of the disease (according to GOLD 2014) with the aim of individualization of further management of such patients.

Aim. To study the relationship between the indicators of dynamic capnography and pulse oximetry with the indicators of the 6-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. 67 patients of both sexes were examined: 45 patients with COPD (age 60.02.74 years) and 25 patients of the control group (age 47.603.46 years). The study of the functional capabilities of the patients respiratory system was carried out before, during and after the 6MWT on the equipment LifeSense LS1-9R capnograph-pulse oximeter (MedAir AB). Results and discussion. In the comparison group, the parameters of dyspnea at rest were higher than the control group (p0.05), the spirometry indices were significantly lower (p0.05). Shortness of breath as a reason for stopping/slowing down the pace during the 6MWT was noted by patients of both groups (p0.05). When analyzing the PETCO2 trend graphs, periodic breathing (PВ) was revealed. In the group of patients with COPD, signs of PВ in the analysis of the PETCO2 trend were found in 80.95% (p0.05). Regression analysis of Cox proportional risks of mortality in patients with COPD revealed the prognostic value of the following parameters of a comprehensive assessment of the patient: body mass index (BMI), BODE index, dyspnea index on the mMRS scale, Borg, forced expiratory volume in 1 second (FEV1), index Tiffno, signs of PВ, distance 6MWT, signs of PВ and desaturation during 6MWT. At the same time, the total contribution of these indicators to the risk of a lethal event was assessed (p=0.003). Conclusion. When analyzing the correlation dependence, it was revealed that the presence of PВ was a prognostically unfavorable sign in patients with COPD. Predictors of an unfavorable course of COPD were BMI (23.0 kg/m2), BODE index, dyspnea indices on the mMRS, Borg, FEV1 scales, Tiffnos index, signs of PH, distance 6MST, signs of PD and desaturation during 6MST (reliability of the model coefficient p=0.003) in terms of forecast.