[Inducibility of arterialized capillary blood gases and acid-base balance determination ].

The reproducibility of determining gases and acid-base balance (ABB) in the arterialized capillary blood taken by 1 and 2 earlap punctures at an 3-15-min interval for up to 7-28 days was studied in 171 subjects (16 healthy individuals and 155 patients with tuberculosis and other diseases of the lung. No relationship was found between the reproducibility of paO2, PaCO2, and SO2, the duration test intervals and that for BE, SB, and pH. The opinion as to the time course of changes in arterialized capillary blood gases and ABB may be regarded as justified only with the changes in paO2 > 4 mm Hg, paCO2 > 2 mm Hg, SO2 > 1%, BE > 0.5 mmol x l(-1), SB > 0.6 mmol x l(-1), and pH > 0.01 at shorter test intervals, BE > 1.1 mmol x l(-1), SB > 0.8 mmoll x l(-1), and pH > 0.02 at longer test intervals.

[Function in patients with chronic fibrocavernous tuberculosis].

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, residual volume (RV), R(aw), R(in), R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 62 patients with chronic fibrocavernous tuberculosis. Lung dysfunctions were detected in 96.8% of the patients. Changes in lung volumes and capacities were found in 90.3%, impaired bronchial patency was in 90.3%, and pulmonary gas exchange dysfunction was in 79.0%. The lung volume and capacity changes appeared as decreased VC and FVC, decreased and increased TLC, TGV, RV; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, and FEV1/VC%; and increased R(aw), R(in), R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, PaO2, and decreased and increased PaCO2. The magnitude of the observed functional changes ranges from slight to significant and drastic with a predominance of considerable and drastic changes in lung volumes and capacities and mild impairments of bronchial patency and pulmonary gas exchange function.

[Pulmonary function in patients with focal pulmonary tuberculosis].

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), Raw, Rin, Rcx, DLCO-SB, DLCO-SS/VA, PaO2, and PaCO2 were determined in 40 patients with focal pulmonary tuberculosis. Changes were found in lung volumes and capacities in 75%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 57.5 and 25%, respectively. The lung volume and capacity changes appeared mainly as increased TGV and PRV; impaired bronchial patency presented as decreased MEF50, MEF75, and FEV1/VC%; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, PaO2, and PaCO2. The magnitude of the observed functional changes was generally slight. TGV and PRL increased up to 148-187 and 142-223% of the normal values, respectively; MEF50, MEF75, FEV1/VC%, and DLCO decreased to 59-24, 58-26, 78-57, and 78-67% of the normal values and PaO2 and PaCO2 did to 79-69 and 34-30 cm Hg.

[Pulmonary function in patients with disseminated pulmonary tuberculosis].

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25%, MEF50%, MEF75%, TLS, TGV, pulmonary residual volume (PRV), Raw, Rin, Rex, DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 29 patients with disseminated pulmonary tuberculosis. Pulmonary dysfunction was detected in 93.1% of the patients. Changes were found in lung volumes and capacities in 65.5%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 79.3 and 37.9%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC, FVC, and TLS, decreased and increased TGV; impaired bronchial patency presented as decreased PEF, MEF25%, MEF50%, MEF75%, and FEV1/VC% and increased Raw, Rin, and Rex; pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SS and PaO2 and decreased and increased PaCO2. The observed functional changes varied from slight to significant and pronounced with a preponderance of small disorders, a lower detection rate of significant disorders, and rare detection of very pronounced ones.

[Pulmonary function in patients with infiltrative pulmonary tuberculosis].

Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, pulmonary residual volume (PRV), R(aw), R(in),, R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 103 patients with infiltrative pulmonary tuberculosis. Pulmonary dysfunction was detected in 83.5% of the patients. Changes were found in lung volumes and capacities in 63.1%, impaired bronchial patency and pulmonary gas exchange dysfunction were in 60.2 and 41.7%, respectively. The changes in pulmonary volumes and capacities appeared as increased PRV, decreased VC and FVC, and decreased and increased TGV and TLC; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, FEV1/VC% and increased R(aw) R(in), and R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, and PaO2 and decreased and increased PaCO2. The magnitude of the observed functional changes was generally slight. Significant disorders were observed rarely and very pronounced ones were exceptional.

[Evaluation of the course of chronic obstructive lung diseases according to the classifications of the European Respiratory Society and the Global Initiative on Chronic Obstructive Lung Disease].

In 91 patients with chronic obstructive lung disease (COLD), the severity of this disease according to the Classifications of the European Respiratory Society (ERS) and the Global Initiative on Chronic Obstructive Lung Disease (GOLD) was compared with that of pulmonary dysfunction according to the data of a comprehensive study, involving the determination of bronchial patency, lung volumes, capacities, and gas-exchange function. This follows that the ERS and GOLD classifications are to be positively appraised as they provide an eligible group of patients for clinical practice in terms of the severity of pulmonary dysfunction and that of COLD. However, the concomitant clinical use of both classifications cannot be regarded as justifiable due to that there are differences in the number of detectable grades (stages) of COLD and borderline (COLD differentiating grades (stages) values of EFV1). In this connection, both classifications have approximately equally significant merits and shortcomings and it is practically impossible to give preference to one of them as the best one. The optimal way out of the established situation is to develop a new (improved) classification of the severity of COLD on the bases of these two existing classifications.

[Lung dysfunction in patients with severe chronic obstructive bronchitis].

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TCL, TGV, RV, Raw, Rin, Rex, DLCO-SS, PaO2, and PaCO2 were determined in 36 patients with severe chronic obstructive lung disease (FEV1 < 50% of the normal value). All the patients were found to have impaired bronchial patency and changes in lung volumes and capacities; 83.3% of the patients had pulmonary gas exchange dysfunction. Impaired bronchial patency mainly appeared as decreased FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, Raw, Rin, Rex; altered lung volumes and capacities manifested by increased RV, TGV, and TLC, and by decreased VC and FVC; pulmonary gas exchange dysfunction showed up as lowered PaO2 and DLCO-SS, as decreased or increased PaCO2. The observed bronchial patency disorders varied from significant to severe; functional changes in lung volumes and capacities were mild to severe.

[Lung dysfunction in patients with mild chronic obstructive bronchitis]. / Nuarusheniia funktsii legkikh u bol'nykh s legkim techeniem khronicheskogo obstruktivnogo bronkhita.

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TCL, TGV, RV, Ravt, Riin, Rex, DLCO-SS, PaO2, and PaO2 were determined in 33 patients with mild chronic obstructive lung disease (FEV1 > 70% of the normal value). All the patients were found to have impaired bronchial patency; most (63.6%) patients had lung volume and capacity changes, almost half (45.5%) the patients had pulmonary gas exchange dysfunction. Impaired bronchial patency mainly appeared as decreased MEF50, MEF15, and FEV1/VC%; altered lung volumes and capacities manifested chiefly by increased RV and decreased VC; pulmonary gas exchange dysfunction showed up primarily as lowered PaO2. The magnitude of the observed functional changes was generally slight. MEF50, MEF75, FEV1/VC%, and VC dropped to 59-20 and 79-70% of the normal value, respectively. RV increased up to 142-196% of the normal value; PaO2 reduced up to 79-60% mm Hg.

[Impaired lung function in patients with moderate chronic obstructive bronchitis]. / Narusheniia funktsii legkikh u bol'nykh so srednetiazhelym techeniem khronicheskogo obstruktivnogo bronkhita.

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, RV, Raw, Rin, Rex, DLCO-SS, paO2 and paCO2 were determined in 22 patients with moderate chronic obstructive bronchitis (FEV1, 79-50% of the normal value). All the patients were found to have impaired bronchial patency, 90.9% of the patients had lung volume and capacity changes; pulmonary gas exchange dysfunction was present in 72.7%. Bronchial patency impairments were manifested by a decrease in FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, and an increase in Raw, Rin, Rex. Changes in the lung volumes and capacities appeared as higher RV, TGV, TLC, lower VC and FVC. Pulmonary gas exchange dysfunction showed up as a reduction in pO2 and DLCO-SS a reduction and an increase in paCO2. The magnitude of the functional changes observed in most patients was low. Significant and pronounced disorders were seen in one third of the patients.

[Dynamics of changes in lung function in patients with recurrent tuberculosis and ineffective primary treatment in intensive phase of controlled chemotherapy]. / Dinamika funktsii legkikh u bol'nykh s retsidivami tuberkuleza i neudachami pervichnogo lecheniia v intensivnoi faze kontroliruemoi khimioterapii.

In 51 patients with recurrent tuberculosis and ineffective primary treatment in intensive controlled chemotherapy, VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, Pa02, PaCO2 were measured before, during, and after intensive controlled chemotherapy. Lung function improved in 51.0% of the patients and deteriorated in 19.6%. There was a combination of better and worse lung function in 9.8% of the examinees. The improvement of lung function was observed only during effective chemotherapy, its deterioration was seen mainly during ineffective chemotherapy, rarely during successful chemotherapy. The main cause of better lung function was the resolution of fresh inflammatory changes and that of worse lung function is the cicatricial transformation of lung tissue.

[Significance of bronchospasm in the development of bronchial obstruction in exogenous allergic alveolitis]. / Znachenie bronkhospazma v narushenii bronkhial'noi prokhodimosti pri ékzogennom allergicheskom al'veolite.

In 22 patients with exogenous allergic alveolitis, VC, FVC, FEV1/VC%, PEF, MEF25, MEF50, MEF75 were determined before and after inhalation of berotec in 1 dose and antrovent in 1 dose. Bronchospasm was detected in 50% of patients. Bronchial spasm was the sole cause of bronchial obstruction in 18.2% of patients and a cause of this disorder in 31.8%. The contribution of bronchospasm to the development of bronchial obstruction was decisive in most patients. In 42% of patients, the proportion of the former in bronchial obstruction amounted to 61-100%.

[The role of bronchospasm in the impaired bronchial permeability in sarcoidosis]. / Rol' bronkospazma v narushenii bronchial'noi prokhodimosti pri sarkoidoze.

VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75 were registered in 24 sarcoidosis patients before and after inhalation of 1 dose of berotec and 1 dose of atrovent. Bronchospasm took place in 20.8% patients. Bronchospasm was the only cause of bronchial obstruction in 16.7%, one of the causes in 4.2%. Contribution of bronchospasm to development of bronchial obstruction was essential in all the examinees (91-100%).

[Significance of bronchospasm in the development of bronchial obstruction in lung diseases]. / Znachenie bronkhospazma v razvitii bronkhial'noi obstruktsii pri zabolevaniiakh legkikh.

VC, FVC, FEV1/VC%, PEF, MEF25, MEF50, MEF75 were studied in 254 patients with lung diseases with bronchial obstruction before and after berotec and antrovent inhalation. Bronchospasm was detected in most patients with bronchial asthma, in a half with exogenous allergic alveolitis, in more than a third with chronic bronchitis and pulmonary tuberculosis, and in a fifth with pulmonary sarcoidosis. In most examinees with bronchospasm, the proportion of the latter in bronchial obstruction amounted to 61-100%.

[Changes in lung function in patients with newly-diagnosed tuberculosis during treatment with short courses of controlled drug therapy]. / Izmeneniia funktsii legkikh u bol'nykh vpervye vyiavlennym tuberkulezom pri lechenii korotkimi kursami intensivnoi kontroliruemoi khimioterapii.

In 54 new cases of tuberculosis, VC, FVC, FEV1, FEV1/VC%, PEF, MEF25, MEF50, MEF75, PaO2, PaCO2 were measured before, during, and after a short-term intensive controlled chemotherapy. Lung function improved in 57.4% of patients and deteriorated in 22.2%. There was a combination of better and worse lung function in 7.4%. The direction of functional changes depended on the form of tuberculosis, the extent of a tuberculous process, the duration and efficiency of chemotherapy.

[Pulmonary function changes induced by bronchial asthma in children, teenagers and adults]. / Izmeneniia funktsii legkikh u detei, podrostkov i vzroslykh, bol'nykh bronkhial'noi astmoi.

The study has established that pulmonary dysfunctions in bronchial asthma are less marked in children and teenagers than in adults. The magnitude of pulmonary dysfunctions are chiefly determined by the severity of bronchial asthma. There was a less close relationship of pulmonary function to the duration of bronchial asthma. There was no association of the severity of pulmonary dysfunctions with the duration of bronchial asthma.

[Role of bronchospasm in development of bronchial obstruction in chronic bronchitis]. / Rol' bronkhospazma v razvitii bronkhial'noi obstruktsii pri khronicheskom bronkhite.

AIM: To clarify the role of bronchospasm in impairment of bronchial permeability in chronic bronchitis. MATERIALS AND METHODS: Lung capacity (LC), forced lung capacity (FLC), forced expiration volume for 1 second (FEV1), FEV1/LC%, peak volume rate (PVS), maximal volume expiration rate (MVER) at the level of 25, 50 and 75% of LC were measured in 62 patients with chronic obstructive bronchitis before and after inhalation of 1 dose of berotec and 1 dose of atrovent. RESULTS: Bronchospasm was present in 42% of the patients, being the only cause of obstruction in 5% of patients. Other reasons added in 37%. Bronchospasm contribution to obstruction reached 21-40, 41-80, 81-100% in 5, 10 and 27% of patients, respectively. CONCLUSION: An important role of bronchospasm in development of bronchial obstruction in chronic bronchitis is proved.

[Role of bronchospasm in impairment of bronchial permeability in bronchial asthma in attack-free period]. / Znachenie bronkhospazma v narushenii bronkhial'noi prokhodimosti pri bronkhial'noi astme v mezhpristupovom periode.

Lung capacity (LC), functional lung capacity (FLC), FEV1, FEV1/LC%, CO25, CO50, CO75 were measured in 56 patients with bronchial asthma in attach-free period before and after inhalation of one-dose berotec and one-dose atrovent. Bronchospasm was registered in 66% of the patients. It was the only cause of bronchial obstruction in 12% of the patients and one of the causes in 54% of them. Contribution of the bronchospasm to development of bronchial obstruction was, as a rule, dominating. This contribution reached 81-100% in 60% of the patients.

[Prospects for development of functional diagnosis in antituberculosis institutions in the Russian Federation]. / Perspektivy razvitiia funktsional'noi diagnostiki v protivotuberkuleznykh uchrezhdeniiakh Rossiiskoi Federatsii.

The author proposes a programme for improving the functionally diagnostic service of antituberculosis institutions, which envisages studies of major spirographic parameters, the forced expiratory flow-volume curve, blood gases and acid-alkali balance in all antituberculosis institutions, global plethysmography, examinations of the diffuse capacity of the lung and spiroergometry in the regional, republican dispensaries and research institutes of tuberculosis and phthisiopulmonology. Studies of lung function are considered to be a mandatory part of clinical examination of patients with tuberculosis in the diagnosis of lung disease, during treatment and after its completion.

[Pulmonary elastic pressure as an indicator of lung tissue morpho-functional restructure]. / Elasticheskoe davlenie legkikh kak pokazatel' morfofunktsional'noí perestroíki legochnoí tkani.

The examination of 100 patients with tuberculosis and exogenous allergic alveolitis showed it expedient to study pulmonary elastic pressure in patients without or with or X-ray signs of pneumosclerosis and pulmonary emphysema. Its exploration could diagnose initial (pre-X-ray) manifestations of pneumosclerosis and pulmonary emphysema in the former patients and specify the extent and relatively significant manifestations of these abnormalities at the subsequent (X-ray detected) stages in the others.