Search

A method permitting the differentiation between the types of pulmonary inflammatory processes in patients with nonspecific diseases of the respiratory organs by the parameters of blood plasma acid-soluble fraction is suggested. If the inflammation is of an infectious origin (pneumonia, chronic bronchitis), the ratio of low-molecular to high-molecular fractions of the blood plasma acid-soluble fraction is 4.2 +/- 1.8. In allergic inflammations (bronchial asthma) this ratio is 9.0 +/- 5.8. The results of this test were in line with clinical laboratory and x-ray findings in 86.7% of the examinees. In complex with other methods of examination, the described technique may be used for the differential diagnosis of allergic and infectious inflammations in patients with respiratory diseases.

The authors review the therapeutic aspects of lung carcinoma (LC) diagnosis based on the follow-up of 80 patients with LC referred to the hospital for different nonspecific pulmonary diseases (pneumonia, bronchitis, bronchial asthma). Point to the diagnostic significance of the therapeutic microsymptomatology (inexplicable leukocytosis, fever, alterations in the character of cough and sputum, appearance of asphyxia and so forth), measurement of the level of hormones and biologically active substances with regard to the clinico-roentgenological appearance in identification of LC in the general therapeutic departments of the hospital. Analyze the diagnostic errors in the patients' group under examination.

The paper is concerned with the results of a study of the nature of immunological disorders in 150 patients with chronic bronchitis and preasthma and in 203 patients with bronchial asthma (BA). Subpopulation analysis of immunocompetent cells with the help of monoclonal antibodies permitted the detection of certain differences in the regulatory link of immunity in patients with different types of chronic nonspecific pulmonary diseases. Patients with purulent bronchitis demonstrated a decrease in the level of the population of T-helpers and a tendency to an increase in the level of T-suppressors, whereas preasthmatic patients demonstrated a decrease in the level of T-helpers in parallel with a sharp deficiency of T-suppressors. An analysis of immune disorders in BA patients revealed the same line of immunological shifts as in preasthmatic patients, however a degree of the affection of the suppressor systems was much greater. The study has shown that immune disorders typical of BA, are revealed even at the early stages of disease, i.e. at the preasthmatic stage. Possible immune mechanisms of pathogenesis of chronic bronchitis, preasthma and BA are discussed. A conclusion is made that immunological investigation including the determination of the levels of T-helpers and T-suppressors and their ratios (the so-called immunoregulatory index) in combination with other methods makes it possible to detect persons at risk of developing BA, at the early stages of development of disease. Immunocorrective therapy is recommended to such patients to prevent development of chronic bronchitis into BA.

The paper is concerned with the results of a study of efficacy of rehabilitation of 1174 patients with chronic nonspecific pulmonary diseases in sanatoria. On the basis of clinical criteria and the results of bicycle ergometry 4 clinicofunctional groups of patients were defined. A tactical approach to the differentiated use of different types of therapeutic, physical and psychic rehabilitation was worked out for these groups. An index method for assessment of the efficacy of rehabilitation based on 5 groups of symptoms was proposed. Therapeutic efficacy in different clinicofunctional groups varied from 89.6% in the 1st group to 71.8% in the 4th group; it was higher among the patients with chronic nonobstructive bronchitis (from 89 to 98%) than among the patients with chronic obstructive bronchitis and bronchial asthma (from 70 to 80%).

Altogether 792 patients admitted to the hospital with a diagnosis of bronchial asthma were under observation. The diagnosis was confirmed in 513 (64.8%) patients and was not confirmed in 279 patients. Of these, 148 (53.2%) were diagnosed to have chronic obstructive bronchitis, 80 (28.7%) a bronchospastic syndrome coupled with exacerbation of chronic (in 69) or acute pneumonia (in 11). In 25 (9%) patients, the clinical manifestations were associated with cardiac asthma attacks, 14 (5%) had tumors of the bronchi, trachea or metastatic lung lesions which gave rise to the development of the bronchospastic syndrome. Eight (2.8%) patients were diagnosed to have tracheobronchial dyskinesia, 1 primary lung emphysema, 1 hysteria, 1 pulmonary tuberculosis, and 1 a foreign body. Differential diagnosis between bronchial asthma and the bronchospastic syndrome is presented.