MODERN APPROACHES TO DIAGNOSTICS OF GLUCOCORTICIDES-INDUCED OSTEOPOROSIS IN PATIENTS WITH BRONCHIAL ASTHMA

Nowadays, patients with bronchial asthma at the stage of providing medical care do not pay enough attention to timely diagnosis and treatment of concomitant osteoporosis. The latter often occurs in such patients in the second place because of systemic inflammatory process, severe hypoxia developing because of respiratory failure, decreased physical activity, inhaled and systemic glucocorticoid use. Inclusion of synthetic derivatives of natural glucocorticoids in the arsenal of necessary drugs for modern bronchial asthma therapy suggests the possibility of developing glucocorticoid-induced osteoporosis in such patients. Therefore, the aim of our investigation was to study the frequency and char-acteristics of the formation of GC-induced osteoporosis in patients with bronchial asthma. To achieve this goal 65 patients with bronchial asthma were screened. They had been treated at the allergic department of the Ivano-Frankivsk Regional Clinical Hospital. All patients had been evaluated the function of external respiration using spirometry and determined the mineral density of bone tissue and the T-criterion of the forearm through X-ray densitometry. It has been established that bone marrow metabolism is more often observed in patients with bron-chial asthma than in a group of practically healthy people. Most of the indicators were changed in a group of patients with severe bronchial asthma and the lowest lung function indicators. Our study showed a dose-dependent decrease in bone mineral density in patients who took systemic (several courses per year) and oral glucocorticoids, which was not noted for the use of these drugs inhalation in low and medium doses. Taking into account the fact that osteoporosis does not have pathognomonic symptoms and its clinical manifestations are rather vague for the early detection and treatment of this condition in pulmonary pathology, it is necessary to use X-ray densitometry. This will prevent the development of complications in particular the emergence of low-energy fractures. Conclusions: 1. In patients with asthma a higher proportion of development OP often associated with using of GC (several courses per year parenterally or orally), was established in patients with asthma than in patients without pulmonary disease. 2. The expressiveness of changes in BMD has a direct proportional dependence on the severity of the course, the degree of asthma control, the limitation of physical activity in such patients. 3. To reduce potentially possible systemic effects in patients with asthma it is recommended to use small and medium doses of inhaled corticosteroids now. 4. For timely diagnosis of changes in bone me-tabolism in such patients osteodensitometry should be performed with subsequent correction of the revealed violations.