Predictors of bronhial asthma control decrease in smokers

Objective. The aim of the research is to reveal factors which influence bronchial asthma control. Materials and Methods. A total of 138 young patients were examined, including 103 patients with persistent bronchial asthma (BA) and 35 healthy non-smokers (control group). Research methods included spirometry (Spirosift-3000, Fukuda Denshi Corp., Japan) and transcutaneous pulse oximetry (Mr-110, MEK, Korea). Exhaled carbon monoxide (FeCO) and the level of carboxyhemoglobin (HbCO) were measured by a Micro CO monitor (Micro Medical, UK) and by the Smoke Check monitor (Medical Micro, UK). Evaluation of morphofunctional characteristics of the circulating pool of red blood cells was carried out using hematology analyzer COULTER® HmX. The assessment of BA control level was conducted in two main ways: using the Asthma Control Test (ACT) and Asthma Control Scoring System (ACSS). Results. Smokers with BA demonstrated more serious airway inflammation according to the level of exhaled carbon dioxide. It led to embarrassment of ventilation (obstructive type) with impairment of blood oxygenation and changes in morphological and functional characteristics of erythrocytes. Smoking in the main group of patients with BA caused more distinct adaptive changes of morphological and functional characteristics of red blood cells. In comparison with the control group smokers demonstrated increased number of red blood cells, increased Hb level, increased Hb concentration in red blood cells, and severe anisocytosis. The abovementioned changes of pulmocardiac system in smokers with BA lead to lack of disease control primarily affecting the functional component of the total control in combination with increase of clinical asthma control.