Diagnosis of bronchial asthma: criteria and methods

To date, bronchial asthma isan urgent problem of practical public health throughout the world. The results of major studies in this area have shown an increase in the number of patients who are diagnosed with this ailment and the mortality rate among them. Diagnosis of bronchial asthma is a rather complex and multi-stage process. The initial stage of the diagnosis is the questioning of the patient (collection of anamnestic data) and his clinical examination, which in many cases correctly diagnoses. Poll means the clarification of the patient's complaints, as well as the identification of a possible evolution of the disease over a certain period of time.

Diagnostic criteria of bronchial asthma

Diagnosis of bronchial asthmaIt is facilitated by using certain criteria. Diagnostic criteria can be divided into basic and additional. The main diagnostic criteria for the prognosis of 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 appearance in the patient of signs of hyperreactivity of bronchi with the help of provocative samples (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

Investigation of respiratory function in a patientailment, 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 effectiveness of future treatment. The main methods of diagnosing bronchial asthma include:

Spirography - 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.
Pikfluometriya - a method of diagnosing bronchial asthma based on determining the maximum air volume velocity during peak expiration after a full inspiration.

When diagnosing this disease, to excludeother diseases, sometimes appoint a computerized tomography and chest X-ray. The blood test, IgE determination and other diagnostic methods are additional and do not play a decisive role in the choice of treatment methods.