Overview
Bronchial asthma (BA) is a complex medical, socio-economic problem. Up to 10% of the world's population suffer from various types of AD. Asthma develops in childhood (50%) and in adults under 40 years of age. The prevalence and severity of bronchial asthma are influenced by genetic factors, climate, environmental conditions, nutrition, endocrine pathologies, and immunodeficiency states.
What is bronchial asthma?
Bronchial asthma is a chronic inflammatory disease of the airways, accompanied by their hyperreactivity, which is manifested by repeated episodes of shortness of breath, difficulty breathing, a feeling of pressure in the chest and cough, occurring mainly at night or in the early morning. These episodes are usually associated with widespread but not permanent airflow obstruction that is reversible, either spontaneously or with treatment.
Classification:
Classifications of bronchial asthma according to etiology, severity of the course and peculiarities of the manifestation of bronchial obstruction are of the greatest practical importance.
♦ Stage 1: mild intermittent (episodic ) asthma .
Symptoms (cough, shortness of breath, wheezing) are noted less than once a week. Night attacks no more than 2 times a month. In the interictal period, there are no symptoms, normal lung function (FEV 1 and PSV more than 80% of the expected values), daily fluctuations in PSV less than 20%.
♦ Stage 2: mild persistent asthma.
Symptoms occur once a week or more often, but not daily. Night attacks more than 2 times a month. Exacerbations can interfere with normal activity and sleep. PSV and FEV 1 outside the attack more than 80% of the proper values, daily fluctuations in PSV 20-30%, indicating an increasing reactivity of the bronchi.
♦ Grade 3: moderate persistent asthma.
Symptoms occur daily, exacerbations disrupt activity and sleep, reduce quality of life. Night attacks occur more often than once a week. Patients cannot do without daily intake of short-acting β 2 -agonists. PSV and FEV 1 are 60-80% of the proper values, fluctuations in PSV exceed 30%.
♦ Stage 4: severe persistent asthma.
Persistent symptoms throughout the day. Exacerbations and sleep disturbances are frequent. Manifestations of the disease limit physical activity. PSV and FEV 1 are below 60% of the proper values even outside an attack, and daily fluctuations in PSV exceed 30%.
It should be highlighted that these signs can only be used to identify the severity of bronchial asthma before therapy begins. If the patient is currently getting the required therapy, the volume should be considered. If a patient has a clinical picture that corresponds to stage 2 but receives therapy that corresponds to stage 4, he is classified with severe bronchial asthma.