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[Peculiarities of management of the elderly patients suffering from chronic obstructive pulmonary disease].

The authors present the results of an open prospective study undertaken to elucidate the influence of combined treatment of 72 patients presenting with chronic obstructive pulmonary disease (COPD). It was shown that traditional therapy supplemented by physical rehabilitation procedures, psychotherapy, and patient education during 6 months resulted in significant improvement of physical working capacity and mobility of the patients; moreover, it reduced the severity of apnea in the elderly subjects. The combined treatment of patients with COPD modulated the neuroimuunoendocrine status of their respiratory apparatus, enhanced the production of signal bronchodilatory molecules of vasoactive intestinal peptide, and decreased the level of bronchoconstrictor endothelin-1. It is concluded that the observed positive clinical and neuroimmunoendocrine effects of combined therapy give reason to recommend the use of this approach when providing the medical care for the elderly patients presenting with moderately severe COPD.