COMPARATIVE CHARACTERISTIC OF CLINICAL AND FUNCTIONAL FEATURES OF FORMATION OF HYPO- AND HYPEROSMOLAR AIRWAY RESPONSIVENESS IN PATIENTS WITH BRONCHIAL ASTHMA

To study clinical-functional features of formation of osmotic airway hyperresponsiveness, a complex examination of 59 patients with bronchial asthma was done. The study included the detailed interviewing, objective examination to diagnose the severity of the disease and the features of its course, questionnaire to estimate the clinical signs of osmotic airway hyperresponsiveness, the study of lung ventilation function by the spirometry, bronchial challenge tests with the inhalation of distilled water (DWI), NaCl 4.5% solution, dosed exercise test (DET). According to the anamnestic testing, after the change of air humidity the patients had asthma attack in 14% of cases, shortness of breath (54%) combined with increased dyspnea (32%), cough (39%), in some cases hoarseness, nasal blockage (19%), in 34% of cases the patients needed the additional intake of bronchodilator to stop an attack. After the challenge with DWI the symptoms of airway irritation were in 61%, after hypertonic solution inhalation (HSI) they were in 63%; in 13% of patients they were after DET and basically resembled the feelings obtained under amnestic testing. The significant drop of FEV₁ after DWI was registered in 37% of patients (ΔFEV₁=-18.1±2.50%), after HIS it was in 29% (ΔFEV₁=-17.8±1.87%), after DET it was in 18% (ΔFEV₁=-18.9±3.30%). It was found out that neither of the patients responded to all the challenges by simultaneously equal decrease of parameters of bronchial conductance, but there were coincidences in the responses to hypo- and hyperosmolar stimuli introduced in the form of aerosol. The patients who had a positive response to DWI in 58% had an intensive bronchial response to HIS and in 13% they had a positive response to DET. During the study it was revealed that in more than 30% of patients with bronchial asthma there were responses to osmotic stimuli and in 58% there is oversensitivity to the combined effect of osmotic stimuli.

бронхиальная астма, гиперреактивность дыхательных путей, осмотический стимул, asthma, airway hyperresponsiveness, osmotic stimulus

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