Bronchial asthma - a chronic inflammatory disease of the lower respiratory tract characterized by episodic obstruction of bronchi arising due to bronchial hyperreactivity.
Overview
The basis of asthma is a pathological bronchial reactivity: on contact with triggers (factors causing or worsening obstruction attack disease) smooth musculature of the lower respiratory tract is reduced, which leads to a significant narrowing of the lumen, to increase air resistance and offensive asphyxiation.
At the same time, the mucous membrane under the influence of inflammatory mediators, produces thick mucus that, in some cases, departments, can cause blockage of even large bronchi.
Narrowing of the most pronounced exhale (dynamic obstruction). The air remaining in the lumen of the alveoli, causing difficulty exhaling and further hyperextension of the lungs, which in turn leads to an increase in respiratory rate.
The causes of asthma
The causes of asthma are varied and in most cases the individual, which somewhat complicates their identification. They may be associated with a genetic predisposition (as a rule, the disease is present in family history), environmental conditions (Almost all the products of industrial exchanges are triggers of the disease), occupational (prolonged exposure to dust) and physical activity. You also can not rule out cases of asthma as systemic complications of any allergic reaction.
Symptoms of asthma
The main symptom is a sudden onset of dyspnea at which patients take forced position (focus on a table or any other surface, the shoulder belt elevated, the chest expanded and acquires Cylindrical shape), make a short breath and going after a long exhalation, accompanied by stress and characteristic whistling wheezing.
Prolonged pain fit notes at the bottom of the breast, which bind to the diaphragm stress.
There is a clinical form characterized by long bouts of coughing with the department a certain amount of glassy sputum. She, as well as asthma physical effort, the most common in pediatric patients. In this case, the cough occurs at night during sleep and is always preceded by the awakening (asthma physical effort attack follows immediately after exercise).
Before an attack is sometimes r. N. "Aura", which manifests itself urticaria, Runny nose, sneezing or coughing. It lasts usually for several minutes without causing significant inconveniences, and then smoothly moves to attack itself.
Diagnostics
In most cases, definitive diagnosis is sufficient to have a characteristic pattern of disease: shortness of breath, asthmatic aura, difficulty breathing, seizures appearance after exercise or contact with certain substances. However, for final confirmation is necessary to conduct a series of tests:
- Spirometry (definition of speed and volume indices of external respiration) observed volume reduction forced expiratory in the ordinary state and after receiving the increase bronchodilators, and reduced life lung capacity;
- Pikflurometriya (determination of peak expiratory flow rate): a decrease in peak expiratory flow rate and its variability during the day;
- Sputum analysis in asthma is observed a large number of eosinophils, necrotic neutrophils (Charcot-Leyden crystals) and small airways of stitches (Cushman helices). Sputum increased viscosity, two-layer, trudnootdelimaya;
- Complete blood count: there is a pronounced eosinophilia, Increased amounts of total and specific IgE;
- Positive allergic status: positive reaction to one or more allergens as a result of skin, nasal inhalation or conjunctival samples;
- Physics research: the emergence of an attack as a result of the 8-minute run (identification of asthma physical effort).
Treatment
Treatment of asthma is based on the use of drugs with an action, reverse mechanism of the disease.
Distinguish symptomatic and basic treatment:
- The base includes local application antiallergic agents (typically corticosteroids for inhalation use) and risk factors for the disease (identified from samples allergens);
- Symptomatic is to use bronchodilator (expanding the lumen of the bronchi) drugs for relief arising seizure.
It is noted that the use of basic therapy drugs with drugs for symptomatic complex, reduces the likelihood of applying the most recent half, which has a positive effect not only on the treatment of the dynamics, but also increases the chance to favorable outcome.
Forecast
Prediction of disease outcome depends on the patients age, baseline therapy adequacy, and the cause of the disease.
Child patients and asthmatic allergic nature most easily treatable (in most cases the disease ends complete recovery with the onset of adulthood, leaving only a slight decrease in lung performance), and the forecast in almost all cases favorable.
Asthma in the elderly - on the other hand is more difficult, depends entirely on the completeness of the basic treatment and to a certain frequency of cases are fatal.
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