Hospital therapy. Classification of bronchial asthma (BA) (the most important)

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Hospital therapy. Classification of bronchial asthma (BA) (the most important)

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23. Classification of bronchial asthma (BA)

Classification. The predominance of one or another mechanism in the pathogenesis of AD makes it possible to distinguish its various pathogenetic features. Currently, the classification proposed by G. B. Fedoseev (1982) is used.

Stages of AD development.

I - pre-asthma (conditions that threaten development: acute and chronic bronchitis, acute and chronic pneumonia with elements of bronchospasm in combination with vasomotor rhinitis, urticaria).

II - clinically formed BA (considered as such after the first attack or immediately onset of status asthmaticus).

BA forms:

1) immunological;

2) non-immunological.

Pathogenetic mechanisms (clinical and pathogenetic variants) of AD:

1) atopic;

2) infection-dependent;

3) autoimmune;

4) dishormonal;

5) neuropsychic imbalance;

6) adrenergic imbalance;

7) cholinergic imbalance;

8) primary altered bronchial reactivity. Severity of BA:

1) mild course (exacerbations are rare, 2-3 times a year, short-term asthma attacks are stopped by taking various bronchodilator drugs inside);

2) moderate (more frequent exacerbations 3-4 times a year, asthma attacks are more severe and stopped by injections of drugs);

3) severe course (characterized by frequent and prolonged exacerbations, severe attacks, often turning into an asthmatic state). Phases of asthma progression:

1) exacerbation (the presence of recurrent attacks of asthma or asthmatic condition);

2) subsiding exacerbation (attacks become more rare and mild, physical and functional signs of the disease are less pronounced than in the exacerbation phase);

3) remission (typical manifestations of BA disappear: asthma attacks do not occur; bronchial patency is fully or partially restored).

Complications:

1) pulmonary: emphysema, pulmonary insufficiency, atelectasis, pneumothorax, status asthmaticus, etc.;

2) extrapulmonary: cor pulmonale (compensated and decompensated with the development of right heart failure), myocardial dystrophy, etc.

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