Allergic Rhinitis and Quality of Life in Patients with Bronchial Asthma

Bronchial asthma (BA) and allergic rhinitis (AR) are the most widespread allergic diseases. Nowadays, allergic diseases are concerned as a global challenge of medical care due to their sustained expansion: 30-40 percent of Earth population suffers from one or more allergic diseases. Number of patients, who suffer from allergy, has been doubling every decade for last 30 years. According to the World Allergy Organization's (WAO) data, 300 millions of people suffer from BA, and 250 thousands of them die every year. BA and AR significantly impair the quality of life (QL) of patients; these diseases impact social and economic well-being of society. AR is the risk factor of BA development; combination of BA and AR is found out in 15-38 per cent of cases (I.L. Brozek et al., 2010; J. Bousquest et al., 2012). The aim is to assess allergic rhinitis influence on the quality of life in patients with bronchial asthma. Materials and methods It was investigated 30 patients with BA, who took medical care in Kharkiv regional hospital. BA of the 2nd degree (mild persistent) has been diagnosed in 10 patients, BA of the 3rd degree (moderate persistent) – in 12 patients, and BA of the 4th degree (severe) – in 8 patients. Uncontrolled clinical course of BA has been ascertained in 14 patients and partially controlled – in 16 persons. For the research of patients QL general international questionnaire MOS SF-36 has been used. Results of questioning have been calculated with the help of special computer program and represented in points of scale from 0 to 100 (www. sf-36.org/demos/SF-36/html). Statistical processing of data has been used for figures assessment (Excel for Windows 10, STATISTICA 7.0). Results and discussion For the analysis of AR influence on the QL of patients with BA patients were separated into two groups: 1st group included 9 patients with both BA and AR, 2nd group contained 21 patients with BA but without symptoms of AR. It has been found out that parameters of physical health (PCS) have not been significantly different in both groups. Nevertheless, summary parameters of mental health (MCS) such as viability (VT), social functioning (SF), role of emotions (RE) and mental health (MH) have been lower in patients of the 1st group than in the 2nd one. It was defined two sub-phenotypes of patients with BA. Thus, BA sub-phenotype with low parameters of mental health (MCS 34-37 points) has been established in young patients (20-39 y. o.), mainly men with either BA or AR. Meanwhile, BA sub-phenotype with relatively high QL parameters (MCS 39-45 points) has been demonstrated in women, and in patients with normal arterial pressure and without symptoms of AR. Conclusions. The research of QL in patients with BA and AR with the help of general international questionnaire MOS SF-36 has revealed that AR did not affect the physical health of patients with BA. AR has impacted parameters of mental health on patients with BA. To improve treatment and follow-up care of patients with BA and AR two sub-phenotypes, which are characterized by high and low parameters of mental health, have been offered to identify. Patients with BA, who have low parameters of mental health, must follow recommendations strictly of the Protocols for AR and arterial hypertension treatment and the program of their rehabilitation should involve psychotherapeutic care. Following researches are necessary to identify BA and AR biomarkers for patient phenotyping and personification of approaches for allergic diseases diagnostics and treatment.