PURPOSE: To study the state of erythrocyte superficial architectonics in patients with bronchial asthma (BA)with associated disturbances of carbohydrate metabolism in the prognosis of severe asthma development.
METHODS: In 100 patients with BA (age 48,0±2,9 years, disease durability 12,69±1,26 years) receiving basic therapy beta2-AG in doses 936,11±92,95 mcg and sGK in doses up to 54,4±3,36 mg during the period of attacks and up to 10,0±1,46 mg in the period free of attacks during 6,44±1,2 years the glycosylated hemoglobin was determined (HbAIc) by method of Fluckiger R. in modification by E.Abraham (1978). The erythrocyte superficial architectonics was studied with method of scanning electron microscopy describing by G.I.Kozints classification (1977).
RESULTS: In 65,2% of cases in the patients during prolonged treatment with beta2-agonists and systemic glucocorticoids the higher levels of glycosylated hemoglobin were found. In the patients with BA with increased process of glycosylation the frequency rate of identification of degenerative-changed forms of erythrocytes was 1,7 times higher in comparison with the patients without them, 38,1% and 22%, respectively. There was found significant reduction in identification of full diskocytes, 38,7% versus 60,2%. The life period of erythrocytes in this group was shortened to 26 days.
CONCLUSION: This study revealed significant changes in the erythrocyte superficial architectonics indicating reduction of cell deformation during passage through organ microcirculatory beds, an increase in their fragility, fragmentation and degenerative changes.
CLINICAL IMPLICATIONS: This study allows an improved understanding of the association between microcirculatory disturbances, tissue hypoxia, the formation of pulmonary hypertension, and corpulmonale in patients with hyperglycemia and bronchial asthma.
DISCLOSURE: Irina Liverko, None.