The aim of the research was to identify the frequency of development of the syndrome of post-exercise bronchial spasm in patients with asthma against physical load and the study of clinical-functional features of its course. 197 patients (122 women and 75 men) with mild persistent partially controlled and uncontrolled asthma were observed. The mean age of the patients was 36.1±0.73 years old; the mean height was 168.8±0.63 cm; the mean weight was 74.6±1.03 kg. The patients did not have strong obstructive disorders of the ventilation pulmonary function; forced expiratory volume for the first second (FEV1) was 91.6±2.5% from the predicted value. All the patients had clinical-anamnestic test and the assessment of apnoea degree by the scale of mMRC and identification of disease control by validated questionnaire Asthma Control Test; the airway response was evaluated in reaction to dosed physical load calculated and fulfilled at the research complex for ergospirometric studies OxyconPro (VIASYS Healthcare, Germany); basic study of the lung function at the device Easyone-PC (Switzerland) was done. As a result of the study post-exercise bronchial spasm was diagnosed in 18.3% of patients with asthma. Close positive correlation between the baseline FEV1 (in %) and bronchial response to the dosed physical load measured at the first minute of the recovery period (r=0.19; р<0.05) as well as the intensity of the further bronchial response at the 10th minute of the recovery period (r=0.19; р<0.05) was registered. The intensity of bronchial response at the 10th minute of the recovery period in patients with airway hyperresponsiveness to dosed physical load was directly related with the degree of asthma control (r=0.56; р˂0.05). It was found out that the degree of the asthma control correlated with the airway hyperresponsiveness to physical load.
Федеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания», 675000, г. Благовещенск, ул. Калинина, 22РЕЗЮМЕ С целью оценки влияния постнагрузочной ги-перреактивности дыхательных путей на связанное со здоровьем качество жизни больных бронхиаль-ной астмой обследованы 109 пациентов с лёгким и среднетяжелым неконтролируемым и частично контролируемым течением, разделённых на две группы: с наличием и отсутствием гиперреактив-ности бронхов на физическую нагрузку. Качество жизни оценивали при помощи вопросников SF-36 и AQLQ, состояние эмоциональной сферы посред-ством Госпитальной шкалы тревоги и депрессии. Уровень контроля астмы определяли по вопрос-нику АСТ. Функцию внешнего дыхания оценивали посредством спирометрии форсированного выдоха. Оценивалась реакция дыхательных путей в ответ на дозированную физическую нагрузку, выполнен-ную на исследовательском комплексе OxyconPro (VIASYS Healthcare, Германия). В результате иссле-дования установлено, что больные бронхиальной астмой с наличием гиперреактивности дыхатель-ных путей на физическую нагрузку характери-зуются более низким уровнем общего и специфического качества жизни, имеют достоверно худший контроль над заболеванием и неблагопри-ятный психоэмоциональный фон, влияющий на оценку общего и специфического качества жизни.Ключевые слова: бронхиальная астма, качество жизни, гиперреактивность дыхательных путей, фи-зическая нагрузка, контроль над бронхиальной астмой. SUMMARY FEATURES OF THE QUALITY OF LIFE IN PATIENTS WITH ASTHMA AND WITH AIRWAY HYPERRESPONSIVENESS TO PHYSICAL LOAD N.L.Perelman, L.G.Nakhamchen Far Eastern Scientific Center of Physiology andPathology of Respiration, 22 Kalinina Str., Blagoveshchensk, 675000, Russian Federation To assess the influence of postload airway hyperresponsiveness on the quality of life of patients, 109 patients with mild and moderate uncontrolled and partially controlled asthma were examined and divided into two groups: with and without bronchial hyperresponsiveness to physical load. The quality of life was assessed with the help of questionnaires SF-36 and AQLQ, the state of the emotions was determined with the Hospital Scale of Anxiety and Depression. The level of asthma control was found by the questionnaire of ACT. The lung function was evaluated with the help of the spirometry. The airway response to dosed physical exercises done at the research device OxyconPro (VI-ASYS Healthcare, Germany) was assessed. As a result of the study it was found out that the patients with asthma and airway hyperresponsiveness to physical load have a lower level of the general and specific quality of life, a worse control over the disease and unfavorable psycho-emotional state which influences the assessment of general and specific quality of life.
F., Afanas'eva E.Yu. Peculiarities of pulmonary mechanics and gas exchange in asthma patients with different types of reaction to cold and osmotic stimuli. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2020; (77):41-50 (in Russian).
Aim. To establish the relationship of immunological and hemodynamic parameters of the fetoplacental system during exacerbation of chronic bronchitis of cytomegalovirus etiology. Materials and methods. A study was carried out of the concentration of TNFα, IgA, IgM in the blood serum and the systolic-diastolic ratio (SDR) in the right uterine artery (RUA) in 80 women in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of cytomegalovirus infection (CMVI). Three groups were retrospectively distinguished. The first group included 30 patients with CMV seronegative physiological pregnancy, the second group included 25 women with exacerbation of chronic bronchitis caused by CMVI reactivation, initiating the development of chronic compensated placental insufficiency (CCPI), in the third group – 25 pregnant women with chronic bronchitis in the acute stage, induced by CMVI, leading to the formation of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation. Results. In the first group, the concentration of TNFα in the blood serum was Me 16.4 (13.1–33.8) pg/mL, IgA – Me 2.5 (2.23–2.62) mg/mL, IgM – Me 0.99 (0.87–1.56) mg/mL, and SDR in RUA – Me 1.95 (1.87–2.30). In the second group, compared with the first one, there was an increase in the concentration of TNFα by 4.95 times (p=0.000001), IgM − by 2.51 times (p = 0.000001) and SDR in RUA by 1.25 times (p = 0.000001) with a 1.49-fold decrease in the IgA level (p = 0.000001). In the third group, compared with the first one, there was an increase in TNFα by 6.12 times (p = 0.000001), IgM − by 2.98 times (p = 0.000001) and the value of SDR in RUA by 1.70 times (p = 0.000001) against the background of a 2.31-fold decrease in IgA concentration (p = 0.000001). In patients of the third group, in comparison with the second group, higher levels of TNFα (by 1.23 times, p = 0.000001), IgM (by 1.18 times, p = 0.000001) and SDR in the RUA (by 1.35 times, p = 0.000001), as well as lower values of the IgA concentration (1.54 times, p = 0.000001). Conclusion. In women with exacerbation of chronic bronchitis caused by CMVI reactivation, leading to the formation of CSPI, in contrast to patients with a similar bronchopulmonary pathology of cytomegalovirus origin and the development of CCPI, a more pronounced activation of the systemic inflammatory response and an imbalance in the humoral component of immune system lead to an increase in vascular resistance in the RUA pool.
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