Цель работы-проанализировать методику бронходилатационного теста (БДТ) на обратимость на различные дозы сальбутамола у больных бронхиальной астмой и хронической обструктивной болезнью легких (ХОБЛ). Материалы и методы. Обследовали 80 больных с бронхообструктивным синдромом: 50 человек с легкой персистирующей бронхиальной астмой (I группа) и 30 пациентов с ХОБЛ средней тяжести (тяжесть В, II группа). У всех больных применяли рутинные методы исследования: общеклинические, лабораторные, исследование функции внешнего дыхания, рентгенография органов грудной полости (при необходимости), статистические методы. Результаты. Для исследования пациентов с БА и ХОБЛ использовали 2 методики проведения БДТ, которые отличались дозой сальбутамола. Сначала всех 50 больных БА обследовали на обратимость бронхообструкции с 200 мкг сальбутамола, затем (как правило, через 2 недели) 400 мкг сальбутамола. У больных БА обратимость имела место у всех больных БА после 200 мкг сальбутамола уже через 15 минут, но у 30 больных (60 %) она была полной (12 % и более от предыдущей, >200 мл), у 20 больных-частичной (менее 12 %, или 200 мл); через 30 минут полная обратимость получена у 46 из 50 больных (92 %), через 45 минут она составляла 12 % и более (>200 мл) у всех пациентов. При использовании дозы сальбутамола в 400 мкг при БДТ получены следующие результаты: через 15 минут полная обратимость установлена у 47 (94 %) больных, через 30 минут еще в 3 пациентов, то есть в всех больных БА. Сальбутамол в дозе 200 мкг через 15 мин не дал обратимости у 16 (53,3 %) больных ХОБЛ, частичная обратимость была у 14 (46,7 %) больных; через 30 мин частичную обратимость получили еще у 10 пациентов (33,3 %), у 6 больных (20,0 %) не получили обратимости или она была в пределах 2-3 %; только через 45 мин неполную обратимость получили еще у 4 из 6 больных (всего 93,24 %), у 2 больных обратимость отсутствовала после 60 минут исследования. БДТ при дозе сальбутамола в 400 мкг через 15 минут показал неполную обратимость у 26 (86,6 %) больных ХОЗЛ, через 30 минут еще у 3 (96,6 %) пациентов, через 45 минут у всех больных; полной обратимости не обнаружили.

The aim of the study was identifying the features of infection in the site, clinical course of the disease, amount and frequency of patient examinations, family doctor communications and treatment of patients with pneumonia caused by SARS-Cov2. Materials and methods. We examined 23 families of 2–6 members (a total of 78), among them 41 patients with SARS-COV-2 pneumonia. The amount of patient examination (PCR, plain X-ray and CT of the thoracic cavity, coagulogram, blood oxygen saturation) and treatment extent (antibacterial, anticoagulant and oxygen therapy) were considered. Results. The contagiousness of the disease in the families of patients was from 33 % to 100%. The thoracic CT overuse: 73.3 % repeated, 33.0 % triple. Family doctors monitored the treatment only in 14.6 % of cases. The antibacterial therapy administration was 2 times more often than necessary; the treatment was changed by patients themselves or their acquaintances. A hospitalization was offered to patients with a decreased blood oxygen saturation of 92 % and below (29.3 %), and only 2 patients agreed to it. In a lack of treatment efficacy, the patients used respiratory fluoroquinolones (levofloxacin, moxifloxacin), meropenem, linezolid, amikacin, which are among the main drugs for the treatment of resistant tuberculosis. Extensive misuse of antibacterial drugs unnecessarily will result in an alarming increase in antibiotic-resistant infections after the COVID-19 pandemic. Conclusions. Pneumonia caused by SARS-COV-2 is a highly contagious disease in a family cluster (33–100 %). Routine administration of antibacterial drugs (especially levofloxacin, moxifloxanemine, meropenem, linezolid, amikacin) for patients with suspected SARS-COV-2 pneumonia by thoracic CT or PCR-confirmed without proven need is not only unnecessary, but even dangerous due to the potential increase in resistance to these drugs, which are the primary in the treatment of resistant tuberculosis. The anamnesis of the disease, oxyhemometry and coagulogram are of great importance when examining a patient with this pathology.

The aim is to study the frequency and symptoms of post-COVID syndrome in patients with pneumonia caused by SARS-CoV-2, who were treated in an outpatient setting. Materials and methods. Personal monitoring results of the health state of 62 patients who suffered pneumonia caused by the SARS-CoV-2 and were treated in the outpatient setting between May 2020 and September 2021 were analyzed. The patients were divided into 3 clinical groups depending on age, concomitant diseases, and extent of the process in the lungs. The examination results were processed on a personal computer using the statistical package Statistica program, version 10. Results. The prevalence of post-COVID syndrome with the symptoms that characterize it is significantly higher in patients who have not been vaccinated with the COVID-19 vaccine, who have suffered pneumonia caused by SARS-CoV-2 of a moderate-to-severe course with the process extent in the lungs from 25 % to 50 %, with its repeated cases, regardless of age and the presence of concomitant pathologies. Prolonged COVID-19 (early post-COVID syndrome) and post-COVID syndrome are main complications of COVID-19 with the most common symptoms such as general fatigue, depression, impaired memory concentration, sleep disorder, myalgia/arthralgia. Conclusions. Even a mild course of pneumonia caused by SARS-CoV-2 is accompanied by post-COVID syndrome, which requires long-term supervision and practice of rehabilitation techniques for such patients. Treatment of pneumonia caused by the SARS-CoV-2 with the moderate-to-severe course in outpatient conditions leads to an increase in the frequency and severity of the post-COVID syndrome course. Vaccination with a vaccine against COVID-19 to prevent the development of a severe course of pneumonia caused by the SARS-CoV-2 remains an urgent issue. Identified dental manifestations (stomatitis, periodontitis, and periodontal disease) should be considered by dentists in the early period of post-COVID syndrome, and dental pathology examination should be continued during the treatment of pneumonia caused by SARS-CoV-2 in post-COVID syndrome.