Diagnosis of bronchial asthma: criteria and methods

Today, bronchial asthmais a pressing issue in practical healthcare worldwide. The results of large studies in this area have shown an increase in the number of patients diagnosed with this disease and the mortality rate among them. Diagnosis of bronchial asthma is a fairly complex and multi-stage process. The initial stage of diagnosis is a patient survey (collection of anamnestic data) and a clinical examination, which in many cases allows for a correct diagnosis. The survey implies clarification of the patient's complaints, as well as identification of the possible evolution of the disease over a certain period of time.

Diagnostic criteria of bronchial asthma

Diagnosis of bronchial asthmais facilitated by using certain criteria. Diagnostic criteria can be divided into basic and additional. Basic diagnostic criteria for prognosticating bronchial asthma include:

presence of periodic bouts of expiratory choking in the patient, which can take place both spontaneously and under the influence of bronchodilators;
definition of obstructive type of respiratory failure in the study of the respiratory process in the patient (reduction in peak expiratory flow rate, FEV1, maximum volumetric expiratory flow rate);
presence of a biological marker (increased NO content in exhaled air);
the emergence of signs of bronchial hyperreactivity in the patient using provocative tests (physical activity, methacholine, histamine).

Additional diagnostic criteria for the diagnosis of bronchial asthma include:

presence in the patient of an unmotivated cough during sleep or after physical exertion, stiffness in the chest area, wheezing;
positive skin tests with allergens;
The patient has pollinosis, hay fever, eczema, and similar diseases in his family;
The presence in the patient's blood of an elevated level of general and specific IgE (reactive).

Methods of diagnosing bronchial asthma

Study of respiratory function in a patient with this datadisease, using the criteria described above and applying the appropriate diagnostic methods, is an essential condition for an objective assessment of the degree of the disease, its variability, reversibility and the effectiveness of future treatment. The main methods for diagnosing bronchial asthma include:

Spirometry is a graphical recording of lung volume during breathing. The characteristic signs of the disease with this method are:

a decrease in the Tiffno index;

a decrease in the volume of forced air in the first second (FEV1) and forced vital capacity (FVC).

Pneumotachography. Using this method of diagnosing bronchial asthma, peak volume velocity, maximum space velocities at 25%, 50%, 75% FVC and average space velocities are determined.
Peak flowmetry is a method for diagnosing bronchial asthma based on determining the maximum volumetric air velocity during peak exhalation after a full inhalation.

When diagnosing this disease, to excludeother diseases, sometimes CT scans and chest X-rays are prescribed. Blood tests, IgE determination and other diagnostic methods are additional and do not play a decisive role in choosing treatment methods.