SEVERE COURSE OF BRONCHIAL ASTHMA PROGNOSING

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SEVERE COURSE OF BRONCHIAL ASTHMA PROGNOSING

Journal Title: Астма и Аллергия - Year 2019, Vol 1, Issue 1

Abstract

Aim of study – to carry out prognоsis of the influence of risk factors on uncontrolled course of bronchial asthma (BA), decrease of tolerance to physical activity, deterioration of quality of life, development of lung hyperinflation, occurrence of severe exacerbations of asthma. Methods. 160 patients with severe BA were examined, in which at the specialized medical care level the final phenotypes of the disease were established: allergic asthma - in 60,0% of patients (with allergic rhinitis – 34,4 %, polyposis – 3,8 %, atopic dermatitis – 0,6 %) and non-allergic asthma – at 40,0 %. Among these patients, other phenotypes of severe BA were distinguished: BA with a late onset – 40,6 %, BA with obesity – 33,1 % and BA with fixed bronchial obstruction – in 14,4 % of patients. Asthma associated with chronic obstructive pulmonary disease (COPD) was detected in 20,6 % of patients, BA with concomitant diseases – cardiovascular diseases 58,8 %, sleep obstructive apnea-hypopnea syndrome (SOAHS) – 12,5 %, gastro-esophageal reflux disease (GERD) – 10,0 %. Data collection and their mathematical processing were carried out with the help of licensed software products included in the package Micrоsoft Office Professional 2003, license Russian Academic OPEN No Level No 17016297. Statistical analysis was carriedout with the help of mathematical and statistical capabilities of MS Excel. In order to assess the risk of the presence of certain features among the observation groups, the odds ratio and its 95% confidence interval were calculated (CI). To assess the generalized probability of development of individual events under the influence of several risk factors, the Cochran-Mantel-Hensel criterion was used with the help of software Review Manager (RevMan 5.3). Results. As a result of the research, it was found that the prognosis of the severe course of bronchial asthma can reveal the most important factors that affect the severe course of asthma. The severity of the asthma course depends on: the phenotype of the disease, pulmonary function violation, type of inflammation in the tracheobronchial tree, late onset asthma, severe exacerbations, allergic and related pathologies. Therefore timely detection of the phenotype of severe asthma, allergic and concomitant diseases is a topical issue of modern pulmonology. It was determined that early detection of the phenotype of asthma, the main significant risk factors for the development of uncontrolled asthma, reduced tolerance to physical activity, deterioration of the quality of life, the development of lung hyperinflation, the occurrence of severe exacerbations and the timely prescription of adequate basic therapy is the basis of secondary prevention of severe BA. Conclusions: conducted studies indicate that the definition of individual phenotypes of asthma, their clinical features, types of inflammation and concomitant diseases by prognosing method allows to determine the risk factors that significantly affect the severity of the course of asthma and is the basis for prescription of pathogenetically based anti-inflammatory and bronchodilator therapy.

Authors and Affiliations

Y. I. Feshchenko, L. A. Iashynа, K. V. Nazarenko, V. І. Ignatieva, S. G. Opimakh

Keywords

FEATURES OF CHANGES IN THE INDICATORS OF T-CELL IMMUNITY IN PATIENTS WITH DIFFERENT CONTROLLING OF BRONCHIAL ASTHMA AND THEIR PROGNOSTIC VALUE

The aim: to determine the prognostic assessment of T-cell immunity changes which are based on the study of their features in bronchial asthma (BA) patients with its different controllability. Materials and methods. 133...

EP ID EP511326
DOI 10.31655/2307-3373-2019-1-9-14
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