Abstract:

The notion “asthma-COPD cross” (ACC) for patients with clinical signs of bronchial asthma and COPD was introduced.  From 15 to 45 % of population with bronchial obstructive diseases suffer from ACC and its prevalence increases with age. According to the data of epidemiological studies, in average a half of patients with BA in the world cannot reach a control of BA or keep it for a long time. The aim of our research was the determination of the control level and also assessment of symptoms of the disease of patients with BA and COPD. Patients. The study included patients with ACC, older than 30 years. The control included patients with the bronchial asthma and COPD without any signs of these pathologies combination. Methods. All patients underwent the spirography with the analysis of the curve “flow-volume” of a force exhalation and also bodypletizmography (“MasterScreenPneumo”, "CardinalHealth" (Germany)). Al patients were interrogated by the questionnaires: questionnaire for BA symptoms control (ACQ-7), test for BA control (ACT), test for COPD assessment CAT). Results. At comparing parameters of BA control was revealed the reliably worse control in the group of patients with the associated pathology by data of the questionnaire ACQ-7 comparing with patients with BA. The influence of COPD symptoms was also more essential in patients with ACC comparing with one with COPD. At the more expressed degree of the bronchial obstruction, BA control was reliably weaker, whereas the influence of COPD symptoms was more essential. In patients with ACC with the unsatisfactory control of BA (АСQ-7 ≥1,5 points) the mortality prognosis, expressed by BODE index, grows almost in 3 times; inpatients with the severe and very severe influence of the disease effect (САТ > 20 points), the mortality prognosis grows more than in 2 times. The reliable positive correlation was revealed between the results of CAT and ratio of the internal thoracic volume of gases to the total capacity of lungs (ITGV/TLС), that reflects the degree of lungs hyperinflation - (r=0,35; p<0,05). Conclusions. At BA and COPD combination the indices of the disease control are worse than at the bronchial asthma and a bit similar to ones at COPD. Indices of BA control and influence of COPD symptoms on the condition of patients with the associated pathology were mainly negatively changed at the increase of the bronchial obstruction degree. The essential negative influence of the insufficient BA control and the high influence of COPD symptoms on the disease prognosis in patients with associated pathology (BA+COPD) were revealed.

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