scholarly journals CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND BRONCHIAL ASTHMA: HAVE OUR VIEWS ON DIFFERENTIAL DIAGNOSIS CHANGED?

Author(s):  
L. I. Konopkina
2020 ◽  
Vol 24 (4) ◽  
pp. 80-86
Author(s):  
V. I. Trofimov ◽  
D. Z. Baranov

BACKGROUND: a comparative analysis of laboratory and instrumental tests at patients with bronchial obstructive diseases seems very actual due to the wide prevalence of these diseases. THE AIM: to evaluate characteristics of spirometry as well as allergic (total IgE, sputum eosinophils) and infectious (blood and sputum leucocytes, ESR, CRP, fibrinogen) inflammation markers at patients with bronchial obstructive diseases. PATIENTS AND METHODS: 104 case histories of patients with bronchial asthma, chronic obstructive pulmonary disease and overlap were analyzed including age, duration of smoking (pack-years), laboratory (clinical blood test, biochemical blood test, general sputum analysis, sputum culture) and instrumental (spirometry, body plethysmography, echocardiography) tests. Data were processed statistically with non-parametric methods. RESULTS: COPD patients were older than other groups’ patients, had the highest pack-years index. ACO patients were marked with maximal TLC and Raw, minimal FEV1, FEF25-75, FEV1/FVC. Patients with COPD had the highest inflammation markers (leucocyte count, CRP, fibrinogen). CONCLUSION: high active inflammation may cause severe lower airways possibility disorders at patients with COPD. Data related to a possible role of K. pneumoniaе in the pathogenesis of eosinophilic inflammation in lower airways are of significant interest. Patients with ACO occupy an intermediate position between asthma and COPD patients based on clinical and functional features.


Author(s):  
John J. Reilly

Virtually every health care practitioner who provides care to adults will encounter individuals with chronic obstructive pulmonary disease (COPD). Current estimates of the prevalence of the condition vary based on the method of ascertainment: most surveys show that approximately 6% of adults report a doctor's diagnosis of COPD but that approximately 25% have airflow obstruction when assessed by spirometry. COPD is common, morbid, mortal, and expensive: estimates are that 〉20 million U.S. adults have COPD and that it is responsible for 〉120,000 deaths annually with a cost to the U.S. economy of more than $38 billion. This chapter describes the definition of COPD, presenting clinical symptomatology and evaluation, natural history, differential diagnosis, current concepts of pathogenesis, therapeutic options, and the evaluation of a patient with known or suspected COPD considering surgery.


Sign in / Sign up

Export Citation Format

Share Document