Lung hypertension and the possibility of its correction for patients suffering from severe bronchial asthma

Abstract

The study was aimed at the analysis of a possibility of the lung hypertension correction for patients suffering from a severe bronchial asthma with due consideration to various treatment.
48 patients with bronchial asthma were examined. Four clinical groups were specified. The first group (14 patients) took angiotenzin-transforming enzyme inhibitor (iATE) — enalapril with an average dose of 20 mg/day.
The second group (14 patients) took enalapri in combination with the plasmapheresis. The third group (8 people) took plasmapheresis only. The fourths group (12 patients) was a control group. These patients took basic therapy preparations only. These preparations were used for treating patients of all clinical groups.
The basic therapy preparations were cholinolytics, methylxanthines, β-agonists and corticosteroids (by indication). The clinical parameters (number of asphyxia attacks and/or coughing, dyspnea, rales in lungs - cumulative indices), indices of the external respiration function and diastolic pressure in the lung artery were assessed weekly. The latter parameter was determined by the impulse Doppler echocardiography technique on the basis of the flow shape at the iung artery’s vaive. The 6-stage Ali-Sadec-Ali scale (1988) was used for the assessment of diastolic pressure in the iung artery.
Initially all the patients had high diastolic pressure in lung artery (31 ±2,1) Mercury and low FEV₁(49,4±5,1).
After the treatment a reliable diastolic pressure decrease together with the FEV₁ increase was marked for the patients of the first and second groups. The breathing insufficiency has decreased aiso. These first two parameters did not chang for the third and fourths groups however clinical indices authentically improved.
Taking into consideration the results of the fulfilled analysis it is possible to draw a conclusion that in order to reduce the diastolic pressure in lung artery when treating severe bronchial asthma complicated with the lung hypertension, it is possible to use the isolated enalapril treatment or its combination with the plasmapheresis.