Endobronchial biopsy was performed on 10 patients of group I, 10 patients of group II and 5 patients of group III. The biopsy specimen was the same as in patients with CLL. Patients of group I were diagnosed with moderate proliferation or dystrophy of the bronchial epithelium. In patients with groups II and III, histological examination of biopsy specimens determined edema, atrophy of the bronchial mucosa, and in some cases focal squamous metaplasia of the epithelium was observed. In some patients of groups II and III, lymphocytic and plasma cell infiltration of varying severity was detected under the basement membrane. In patients of group I, there was a slight dilatation of capillaries, plethora of arterioles, capillaries and venules. Protein stasis in the vessels of the microcirculatory bed of the bronchi in patients with MM in stages IA and IIA would not be detected lo In patients with group II, dilatation and plethora of arterioles, capillaries, and venules were observed with varying degrees of severity. The number of arterio-venous anastomoses was increased. In some vessels of the microvasculature, accumulation of protein masses was noted. In patients with group III, dilatation of arterioles, capillaries, and venules was also diagnosed with varying degrees of severity. In patients with MM, complicated by CRF, in the vessels of the microvasculature, the accumulation of protein masses was more pronounced than in patients of group II. This can be explained by increased lung function in conditions of azotemic uremia .
In order to study microhemocirculation in the proximal parts of the bronchial tree, 30 patients with MM underwent endobronchal LDF (10 patients from group I, 10 from II and 10 from group III). The results were compared with the data of 20 people from the control group, who were conducted PBS and LDF. In patients with MM in the course of tumor progression, disturbances of microcirculatory blood circulation in the bronchial mucosa were recorded in terms of the nature and severity of the microcirculatory circulation.
The indicator of the microcirculation parameter (PM), which characterizes the state of tissue perfusion, was significantly reduced as MM progressed. In multiple myeloma, impaired microhemocirculation in the lungs and bronchi is primarily due to the syndrome of increased blood viscosity and anemia. In order to minimize the effect of anemia on the PM indicators, in patients with MM groups II and III, the anemic syndrome was stopped before the study. The hemoglobin level during LDF was not lower than 100 g / l, the content of erythrocytes was not lower than 3 × 10 9 / l. Thus, they tried to establish a decrease in the speed of red blood cells in the microvessels, which, in MM, is primarily due to the syndrome of increased blood viscosity. A significant inverse correlation was established between an increase in the serum paraprotein level and a decrease in PM (r = –0.8, P <0.01), between the duration of the disease MM and a decrease in PM (r = –0.64, P <0.05). ), between an increase in the level of creatinine in the blood and a decrease in the PM (r = –0.5, P <0.05).