Efficacy of treatment of bronchial asthma attack in teenagers with partial control over the disease

Abstract

The goal of the research is to evaluate efficacy of treatment of bronchial asthma attack considering hypersusceptibility indices of the respiratory tract to indirect bronchospasmogenic stimulus in teenagers with a partial control over the disease.
The effectiveness of therapy was analyzed according to the severity of bronchial sensitivity to dosed physical activity in 40 adolescents with partially controlled asthma. The patients were randomized. An average age was 14,3±0,2 years, and duration of the disease – (8,0±0,4) years. Considering the index of bronchial instability in teenagers with a partial control over the disease, two clinical groups of observation were formed. The first group included 16 teenagers with the index of bronchial instability more than 25%, and the second group included 24 peers with less pronounced bronchial instability (less 25%). All the children were comprehensively clinically-paraclinically examined, including evaluation of severity of bronchial obstructive syndrome, immunological tests I-II levels, inflammatometry of expired air condensate and spirometry with nonspecific provocation testing. Bronchial instability index (BII) was calculated and nonspecific hypersusceptibility of the bronchi to indirect stimulus (physical exercise) was examined by means of testing with physical exercise followed by inhalation of bronchodilators. Nonspecific hypersusceptibility of the bronchi to direct stimuli was examined by means of inhalation spirometric test with histamine series solutions calculating histamine provocation concentration (PC20, mg/ml) and provocation dose (PD20, mg), decreasing forced expiratory volume (FEV1) to 20% from the initial level.
Evaluation of deobstructive therapy efficacy of bronchial asthma attack in teenagers with a partial control over the disease gives the evidence to consider that during the first days of treatment it should be more active and extensional in teenagers with high bronchial instability, especially in those cases when a child belongs to the cluster of a high risk of development of severe attack of the disease on the basis of the preliminary comprehensive examination. Patients with high bronchial instability received glucocorticosteroids in a comprehensive treatment more often, for example, in 56,3% cases in the form of systemic pharmacological agents. Risk indices of glucocorticosteroid use in patients from I group (BII>25%) in comparison with ІІ group (BII<25%) were the following: 1,5 [95%CІ:1,1-4,6], with odds ratio 5,3 [95%CІ:2,5-10,9].