Shachova O. Diagnostic value of indices of nonspecific bronchial reactivity in adolescents with asthma.

Object - bronchial asthma at teenagers during remission andthe period of remission; goal - to improve treatment and the control of a bronchial asthma over teenagers by an establishment of diagnostic value of parameters of a hypersusceptibility of bronchial tubes, atopic reactance of an organism, expressiveness of inflammatory process of respiratory ways and development of individualized ways; methods - clinico-genealogic, biochemical, sociometric; endoscopy, enzymoimmunoassay; mathematics and the results - The study of diagnostic value of indicators of the bronchial hyperresponsiveness, atopic reactivity and nature of the inflammation of the respiratory tract in 105 adolescents with bronchial asthma, in the period of clinical well-being revealed that bronchial sensitivity to histamine at concentrations less than 1.0 mg / ml could be used as a screening method, and indices of bronchial lability (IBS> 25%) - to confirm the possibility of a serious asthma attack in the near future. Taking into account the bronchial lability significantly increases the posttest likelihood of a serious attack and indicates the likely risk of such event. It is shown that the period of remission of asthma can be divided into three clusters to control the disease. This is a cluster of optimal control when score on ACT-test reaches an average of 22.3 points and clusters of moderate and insufficient control when ACT test has lower rates. Evaluating the structure of clusters with optimal and insufficient control of symptoms of asthma, it was found that the latter was characterized by distinct nonspecific bronchial hyperreactivity in the form of increased sensitivity and reactivity to inhaled histamine and lability in response to measured physical exercises and inhaled salbutamol. However, the preservation of bronchial inflammation should be considered as characteristic, a marker of which is the high content of nitrogen monoxide metabolites in exhaled breath condensate, and more evident atopic reactivity of organism, much of which can be considered by immediate type skin reactions, in this case - with house dust allergens; on the basis of these studies the algorithm of management of patients was designed to address the issue of maintaining or changing controlled individualized treatment in remission or clinical well-being at the background of basic anti-inflammatory therap.