The object of the investigation is to identify the prevalence of professional bronchial asthma among the population of Kursk region and to optimise the therapy of the patients according to GINA 2006.
The methods of the investigation are the analysis of the medical histories of 1512 patients which are registered in Kursk Center of Professional Disease, prospective clinical trial of the patients with professional bronchial asthma.
Results: professional bronchial asthma was detected in 59 cases (4% of the patients with professional diseases), who earlier worked with professional hazard. Women prevail - 75% among the patients. The duration of the disease which is less than 5 years is registered among 14% of the patients, more than 10 years among 76% of the patient population. The majority is the patients of able-bodied population with the age from 30 to 60 - 66%, retirees - 34%. Concerning the level of control the professional bronchial asthma of 51 patients (86%) was partly controled and 8% - uncontroled. Such grades of severity and steps of treatment of professional bronchial asthma were determined: moderate bronchial asthma 2 step of treatment- 8%, bronchial asthma of average severity 3 step of treatment -41%, severe bronchial asthma 4 step of treatment -51% of the patients. Chronic cor pulmonale with Congestive heart failure 2A is diagnosed among 61% of the patients.The ground of the basic therapy is 2 combined medicines: Formoterol/Budesonide (Symbikort) and Salmeterol/ Flutikazone (Seretide). Fenoterol (Berotek N) and Fenoterol/ Ipratropiya bromid (Berodual N) were used according to the requirement. More than the half of the patients recieved Prednizolon enterally (from 10mg to 30mg per day) starting from the first days the disease was detected. All the patients used prolonged theophyllin.
Conclusion: the analysis of the recieved data allowed us to take reasonable steps in order to optimisethe treatment of the patients with professional bronchial asthma. 20 patients (34%) were transfered to the therapy with Symbikort in regimen -SMART (Symbicort Maintenance and Reliever Therapy). In this group of patients the increase of the level of the control of bronchial asthma was noted (the ACT-test was used to estimate the level of control) in comparison with the regimen of the therapy with fixed doses of combined (LABA and ICS) medicines.
The work was submitted to V international scientific conference «Present-day problems of experimental and clinical medicine», Thailand, December 20-30, 2008, came to the editorial office on 14.11.2008.