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Author: Scaleţchi Valentina Degree: doctor of medicine Speciality:  14.00.26 - Phtisiopneumology Year: 2009 Scientific adviser: Constantin Iavorschi doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Phthisiopneumology "Chiril Draganiuc" Scientific consultant: Iuliu Garcuşa-Bojco doctor, associate professor (docent) Institution: Scientific council:

Status The thesis was presented on the 25 December, 2008 Approved by NCAA on the 26 February, 2009 Abstract – 0.39 Mb / in romanian – 0.44 Mb / in russian Thesis CZU 616-072.7:616.24-002.5-33:616.24-001(002): 611.2 2.77 Mb / in russian 127 pages

Keywords

aero-hematic barrier, bronho-alveolar barrier, pneumohemoglobin barrier, histohematic barrier, diffusion capacity, diffusion resistance, convection, obstructive, restrictive disorders, pulmonary transfer-factor total, component tissular, plasmatic, eritrocitary, state hypoxic, arterial, venous hypoxemia, lung tuberculosis, bronchial asthma, chronic obstructive pulmonary disease, idiopathic fibrosis alveolitis, sarcoidosis pulmonary, pulmonary capillary blood volume, hypertension pulmonary

Summary

For examination of functional state of aero-hematic and histohematic barriers was applied the method of single-acting measure of gradients, volumes and speeds of transfer respiratory gases in indicated morpho-functional elements of the respiratory system by the using of oxygen methods Riley-Lilienthal, Rouhton-Forster, arterio-venous method Е. Landis, spirography in an closed respiratory contour, tetrapolary reopulmonography of pulmonary blood current and angiotensiotonography of pressure in artera pulmonary using indices of venous hypoxemia (PvO2), metabolic hyperacidity (BE) and isohidric transport as criteria of severity of hypoxic state of peripheral tissues.

Functional study of aero-hematic and histohematic barriers in 280 patients with pulmonary tuberculosis, chronic obstructive and disseminate pulmonary diseases allowed to search the transfer of oxygen and carbonic gas between atmospheric air and cells tissues, and organs mitochondrion like unitary complete inseparably chain of interdependent processes.

Lung, affected by pathologic processes, put up resistance of different degree to the penetration of atmospheric oxygen in inter- and intracellular space, which increase bring to development of arterial hypoxemia not only in tissues of the affected organ, but to the development of venous hypoxemia at the level of histohematic barrier, and in result – to the hypoxic state of all organism: respiratory and unrespiratory hypoxia.

Causes of hypoxia state in different chronic pulmonary diseases are:

• tissular component disorder (TtisO2) of pulmonary transfer-factor in lung tuberculosis, idiopathic fibrosis alveolitis and sarcoidosis pulmonary;
• functional state disorders of convective component of aero-hematic barrier in bronchial asthma;
• functional state disorders of the diffusional component of aero-hematic barrier in chronic obstructive pulmonary disease;
• the compensatory role of blood volume indices disturbance in functioning pulmonary capillars in all chronic respiratory diseases ;
• venous hypoxemia is criteria of hypoxic state of peripheral tissues.

The study of O2 diffusion processes in respect respectability with idea about the respiratory system barrier structure by non-invasive systemic method of transfer-factor Riley-Lilienthal, Rouhton-Forster, and arterio-venous method Е. Landis gives the possibility examine the respiration in an common integrity, and not through particular components; determine earlier diagnosis of location level and degree of bronchial obstruction, different forms of pulmonary hypertension, blood venous congestion in pulmonary circuit, initial manifestation of alveolar tissue fibrosis, determine localization and character of morpho-functional causes of hypoxic state, diversity of which is determined by the nosologic form, severity of process evolution and treatment efficacy of the basic pulmonary disease; objectively evaluate arterial and venous hypoxemia, receive the information about respiratory causes of hypoxemia, such pulmonary fibrosis, determine the form and severity of pulmonary, cardiac, pulmono-cardiac, cardio-pulmonary and circulatory and transport respiratory insufficiency; degree and expression of respiratory disorder in whole too.

Oficial Reviewers

• Aurel Saulea
  doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
• Sergiu Pisarenco
  doctor habilitat, associate professor (docent), Public Medical Sanitary Intitution Institute of Phthisiopneumology "Chiril Draganiuc"

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