Yer'omenko G. The acid-base state of the blood and the acid-excretory function of kidneys of patients suffering from bronchial asthma and methods of their correction.

Object of the study: bronchial asthma (BA) of a moderate degree of severity with different degrees of control. Purpose of the research: to improve the efficacy of diagnosing and treating BA of a moderate degree of severity with regard for indices of the acid-alkali state and the acid-excretory function of the kidneys. Methods of the research: general clinical-laboratory and biochemical examinations, computed spirometry with the analysis of "flow-volume" curves of forced expiration, peak-flowmetric monitoring, statistical indices. Theoretical and practical results: the conducted studies made it possible to supplement the existing notions about changes in the acid-alkali state in BA patients. A prognostic meaning of disturbances in the acid-alkali state and canalicular functions in patients with a moderate degree of BA and different degrees of control was determined. The practical value of the work consists in the application of 4.2 % buffered sodium hydrocarbonate solution to complex therapy of BA patients, thereby making it possible to improve the patients' treatment. The complex therapy was clinically approbated, with resultant data which demonstrate a directed action and efficacy of using 4.2 % buffered sodium hydrocarbonate solution in patients with a moderate degree of BA and metabolic acidosis. Practical recommendations and conclusions of the work can be used in the work of physicians of therapeutics, allergology and pulmonology departments of regional, city and district hospitals, particularly at a stage of the dispensary observation of the patients. Novelty: for the first time, the role of the kidneys in compensating disturbances of the acid-alkali state with different degrees of control over a moderate degree of BA was studied. It was shown that an exacerbation of a moderate degree of BA developed disturbances in the acid-alkali state with different directions: respiratory acidosis, metabolic acidosis, metabolic alkalosis. It was found out that a decrease in the control over the BA course was accompanied by disturbances in the functional state of the kidneys: a reduced glomerular filtration, canalicular dysfunctions. It was proved that the kidneys took an active part in the compensation of the respiratory and metabolic acidosis by increasing the excretion of titrating acids and ammonium ions. It was revealed that the administration of 4.2 % buffered sodium hydrocarbonate solution produced a nephroprotecting effect and influenced positively the acid-excretory function and ammoniogenesis. Degree of introduction: results of the thesis were introduced in therapeutics departments of central district hospitals of Pervomaysk and Chuguev, allergology department of Kharkiv Regional Hospital, Vinnitsa Regional Tuberculosis Dispensary. Sphere of application: medicine, therapy.