Asthma
Chronic inflammatory disease of the airways. In the presence of susceptibility is an inflammation causes recurrent episodes of coughing, wheezing, a feeling of chest tightness, breathing is difficult. Inflammation makes the respiratory tract sensitive to allergens, chemical irritants, tobacco smoke, cold air or exercise.
When their effects edema and spasm of the airways, they produced in increased quantity of mucus, and they become hypersensitive to external stimuli. The resultant airflow limitation is reversible (but some patients do not fully) both spontaneously and under the influence of treatment. If carried out an adequate treatment of asthma, inflammation may be reduced for a long time, and the frequency of occurrence of disease symptoms become minimal: disappear and the accompanying problems associated with asthma.
Bronchial asthma is characterized by increased bronchial sensitivity to different allergens, and nonspecific irritants. According to modern classification distinguish three main forms of disease: infectious-allergic (atopic), an infectious-allergic and mixed. According to the severity of the distinguished mild, moderate and severe bronchial asthma.
The disease usually occurs in the classical form: in the form of attacks of breathlessness, alternating with periods of remission. It is usually possible to distinguish 4 periods: predpristupny, seizures, and interictal postpristupny. In severe asthma occur not only individual attacks, but the asthmatic condition. In some cases, asthma occurs in the form of asthmatic bronchitis.
The predominant form of bronchial asthma in children is atopic with participation in the pathogenesis of allergic reaction I, immediate type, which proceeds with the synthesis reaginovyh antibodies. Of cause significant allergens first place belongs to the house dust mite vysokoallergenny consisting of the genus Dermatophagoides (50), second - the pollen of plants (about 30 of cases). In 35 of patients with disease causing house dust and pollen in 20-40 of the atopic form of bronchial asthma accompanied by food allergy, especially among children during the first years of life. Over the past few years has increased the number of cases of allergy to the epidermal allergens.
In addition to the impact of significant non-infectious cause of allergens provokes great importance in the development of asthma attacks are acute respiratory viral infections. It is known that viral infections greatly increase the sensitivity of the bronchi to allergens and other stimuli, increases the permeability barrier disrupts the mucociliary apparatus of the bronchi. In cases of accession to the viral infection of bacterial inflammation of the bronchi even stronger and takes on the character of the mixed (allergic and infectious). Asthma are often instigated and nonspecific effects such as meteorological factors, air pollution, exercise, emotional stress, a sharp odor.
The clinical picture
Asthma often develops at night or early morning hours. Occurring in the daytime attacks are caused by exposure to various allergens and irritants. Attack of asthma begins with a painful cough with difficult expectoration outgoing appear expiratory wheezing with breathing in the auxiliary muscles distant wheezing. In the lungs from both sides listened variegated variety of dry and moist rales, primarily on the exhale. There is tachycardia, increased blood pressure.
Asthma - Diagnosis
To establish the form of the disease and the etiologic diagnosis requires collection of allergy history, staged in the interictal period, taking into account data from medical history of skin tests with allergens, the use of allergy laboratory studies, provocative tests.
Asthma - Treatment
Treatment depends on the period of the disease. During the attack as quickly as it should be cut short by bronhospazmoliticheskih funds belonging to various groups. The most commonly used stimulants of adrenergic receptors in common (adrenaline, ephedrine) and selective (berotek, salbutamol) actions, as well as methylxanthines: aminophylline, theophylline. At the same time appointed mucolytic tools, massage, breathing exercises. With active infection antibiotics are selected according to individual tolerance (preferably not penicillin), the shortest course.
In the interictal period of bronchial asthma caused by allergies to house dust and pollen, in the office or hospital allergy conducted specific immunotherapy (hyposensitization), which gives effect in 75-80 of cases, prior to its need to sanitize the chronic foci of infection (especially in nasopharynx). Specific hyposensitization is incompatible with preventive vaccines and other antigenic effects. Extremely important permanent occupation therapy, physical therapy, good nutrition, treatment of the day with a maximum stay outdoors.
The patient should be a way of life hypoallergenic, active physical treatment, a mild food with the exception of allergenic foods, the maximum limit of harmful non-specific stimuli of the environment (smoke, strong odor), and negative emotional impact.
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