Based on the analysis of the data of spirography, peak flow measurements, pneumotachography and ultrasound methods for examining hemodynamics of the ICC, we can conclude:
1. In patients with MM in the late stages of tumor progression, there is a moderate impairment of ventilation function of the lung in restrictive and mixed types. This is due to a decrease in the elastic capacity of the lungs due to plasma hyperviscosity, lung paraproteinosis, impaired blood circulation in the lungs, specific lymphoid and plasma cell infiltration of the lungs and bronchi, in renal insufficiency by the presence of specific uremic lesions — nephrogenic pulmonary edema, uremic pneumonitis, calcification.
2. As MM progresses, bronchial resistance rises, reaching maximum values in patients with renal insufficiency.
3. In the process of tumor progression in MM, there is a decrease in the parameters of endobronchial microhemocirculation. The leading causes of impaired microhemocirculation in patients with MM are syndrome of increased blood viscosity and renal insufficiency.
4. In patients with MM at the late stages of tumor progression, dysfunction of the vascular endothelium of the microvasculature was diagnosed.
5. Violation of microhemocirculation in patients with MM caused by atrophic changes of the bronchial mucosa. In 40% of these patients, fibrobronchoscopy was diagnosed with bilateral diffuse atrophic bronchitis.
6. After reaching the phase of a stable plateau, the main indicators of the endobronchial LDF are improved, but not fully normalized due to the multifactor nature of the microcirculatory disorders.
7. In the process of development of MM, disorders of general and regional ventilation of the lungs and pulmonary blood flow are progressing, which is characterized by a decrease in ventilation and perfusion indices each zone separately and in general for both lungs. There is a redistribution of ventilation and blood flow from the lower and middle zones to the upper zones of both lungs. These changes are due to the progression of specific myelomatous lesions of the bronchopulmonary system and the diaphragm.
8. In patients with MM with a pronounced osteo-destructive process of the chest, a significant decrease in the excursion of the diaphragm was observed with calm and forced respiration.
9. In patients with MM in the process of tumor progression, the development of pulmonary hypertension is noted. The development of pulmonary hypotension in MM is promoted by: a) hypoxemia due to impaired excursion of the chest and diaphragm, the presence of specific myelomatosis and uremic processes in the lungs, impaired microcirculation and rheology of blood in the ICC vessels, b) endothelial dysfunction, c) myocardial dystrophy, d) acidosis in the presence of renal failure.
10. With the progression of the tumor process there is a violation of the hemodynamics of the ICC. In patients with renal insufficiency, a significant impairment of the systolic and diastolic functions of the right and left ventricles was revealed.