СУРФАКТАНТ-ТЕРАПИЯ В КОМПЛЕКСНОМ ЛЕЧЕНИИ БОЛЬНЫХ БРОНХИАЛЬНОЙ АСТМОЙ. ВЛИЯНИЕ НА КЛИНИЧЕСКИЕ СИМПТОМЫ И ПОКАЗАТЕЛИ ФУНКЦИИ ВНЕШНЕГО ДЫХАНИЯ*

Abstract

The objective of the study : to study the impact of inhalation with natural pulmonary surfactant on clinical signs and changes in external respiration rate in the patients with partially controlled and uncontrolled persisting asthma, and to assess the chances to reduce dependence of the patients on inhalation glucocorticosteroid (iGCS). Subjects and methods . 29 patients with partially controlled and uncontrolled persisting asthma were followed up Persisting asthma was diagnosed as per GINA, 2016. The duration of asthma in the patients varied from 1 to 24 years. All patients received iGCS and long-acting bronchodilators or combination drugs containing them. By the enrollment into the study, patients had been receiving this therapy for at least 6 months. According to the study protocol, after examination patients started to receive inhalation with natural pulmonary surfactant and continued the above therapy. Totally, each patient received 21 inhalations (25 mg per inhalation) in accordance with the schedule during 70 days; after the first inhalation with a surfactant, the patients were followed up for 340 days. No adverse events caused by surfactant and other drugs have been registered during this study. The patients came to see the doctor and to be examined 9 times: on day 1, 8, 15, 29, 41, 70, 160, 250 and 340 of the follow-up. During each visit, the clinical state and external respiration were assessed: FVC, FEV1, FEV1/FVC, and PEF. Results. The positive impact of surfactant therapy was found out: reduction of the frequency of asthma attacks, cessation or reduction of bronchial spasm frequency under moderate physical load. Two-fold and more reduction of iGCS dose was achieved in 19 out of 29 patients (65.5%; 95%CI 47.4-80.1%), and 3 out of 29 (10.3%; 95% CI 3.6-26.4%) patients fully stopped taking iGCS. The subjective data on the state of patients and objective data on the changes in external respiration function showed a confident improvement of the bronchial functions while taking surfactant therapy (day 1-70 of follow-up), and after it (day 71-340 of follow-up).