RESUMEN
The aim of the study was to compare the clinical characteristics and the inflammatory process activity in the airway of patients with severe therapy-sensitive and therapy-resistant bronchial asthma (TSBA; TRBA). The subjects were 171 patients with severe bronchial asthma (BA) aged 18 to 60; the diagnosis was established prior to the study according to GINA 2002 criteria. There were 50 TSBA patients, 121 TRBA, and 50 controls. According to a range of criteria, BA in TRBA was more severe than that in TSBA. TRBA patients displayed significantly higher indices of inflammatory process activity, such as absolute and relative number of eosinophiles and neutrophiles in induced sputum (IS), and IS level of IL-5. Evaluation of IS inflammatory markers in patients with severe BA allowed substantiation of the central role of persistent inflammation as a risk factor of TRBA development.
Asunto(s)
Asma/tratamiento farmacológico , Adolescente , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Agonistas Adrenérgicos beta/administración & dosificación , Agonistas Adrenérgicos beta/uso terapéutico , Adulto , Albuterol/administración & dosificación , Albuterol/uso terapéutico , Antiasmáticos/administración & dosificación , Antiasmáticos/uso terapéutico , Asma/clasificación , Asma/diagnóstico , Asma/genética , Beclometasona/administración & dosificación , Beclometasona/uso terapéutico , Broncodilatadores/administración & dosificación , Broncodilatadores/uso terapéutico , Interpretación Estadística de Datos , Resistencia a Medicamentos , Eosinófilos , Humanos , Persona de Mediana Edad , Neutrófilos , Fenotipo , Esputo/citología , Factores de TiempoRESUMEN
The aim of the study was to evaluate life quality (LQ) of patients with severe bronchial asthma (BA) in connection with the degree of the disease control. Seventy two BA outpatients were divided into two groups: 50 patients with uncontrolled BA, and 22 patients who had achieved full BA control thanks to combined therapy with salmeterol plus fluticasone propionate in a dose of 1000 mg per day during 3 months. Clinical symptoms, respiratory parameters, and daily requirement of broncholytics were under study. General and specialized questionnaires (SF-36; AQLQ) were used to evaluate LQ. The study revealed that full BA control lead not only to improvement of clinical symptoms and positive changes in the respiratory function, but to significant increase of LQ as well. Thus, achievement of full BA control as a complex goal of treatment increases patients' LQ, especially in social sphere.