Ventilation-Perfusion Ability of The Lungs and Pulmonary Hemodynamics in The Dynamics 0f Treatment with Nebivolol In Bronchial Asthma with Pulmonary Hypertension

tact Lens Following Corneal Ventila -tion-Perfusion Ability of The Lungs and Pulmonary Hemodynamics in The Dynamics 0f Treatment with Nebivolol In Bronchial Asthma with Pulmonary Hypertension. Biomed Sci To study effect of сomplex therapy and nebivololi on parameters of ventilation-perfusion function of lang and parameters of diastolic function right ventricle of heard in patients with bronchial asthma complicated by pulmonale hypertension failure. abstract


Introduction
In recent decades, an increase in the prevalence and mortality of patients with severe bronchial asthma (BA) with pulmonary hypertension (PH) has been observed [1][2][3]. Severe BA is one of the causes of LH and accounts for more than 50% in the structure of the formation of pulmonary arterial hypertension (AH) of chronic pulmonary heart [4,5]. Chronic pulmonary hypertension is a serious complication of a number of chronic lung and heart diseases. In addition to vasoconstriction, its pathogenesis includes injury to the peripheral pulmonary arteries leading to their structural remodeling. Increased pulmonary vascular synthesis of an endogenous vasodilator, nitric oxide (NO), opposes excessive increases of intravascular pressure during acute pulmonary vasoconstriction and chronic pulmonary hypertension, although evidence for reduced NO activity in pulmonary hypertension has also been presented. NO can modulate the degree of vascular injury and subsequent fibroproduction, which both underlie the development of chronic pulmonary hypertension [6].
Nitrogen preparations, ACE inhibitors, calcium antagonists, beta-blockers and ozone therapy (OT) against the background of basic treatment are used as correctors of the impaired function of the cardiorespiratory system [7,8]. According to A.G. Chuchalin, V.S. Zadionchenko, A.M. Shchikota, I.V. Pogonchenkova, and others, the mechanism of development of PH and remodeling of the right ventricle of the heart in patients with chronic pulmonary heart is still unclear. The main criteria for early diagnosis and prediction of pulmonary heart development in patients with COPD and severe BA have not been developed [9,10]. According to literature data, Uzbekistan has not developed optimal regimens for the prevention and treatment of patients with PH, taking into account the peculiarities of the course of BA.

Purpose of the Study
To study the state of the ventilation and perfusion ability of the lungs (VAL), pulmonary hemodynamics and right ventricular diastolic function (RVDF) in the dynamics of complex treatment with nebivolol in patients with BA with PH. are processed using the Excel software package, using t -Student's criterion. Differences between the studied parameters were recognized as reliable at p <0.05.

Research Results
According to the VAL, there was a decrease in the ventilation-perfusion state of the bronchopulmonary system in all patients with PH. Thus, the FEV1 index in the 1a subgroup was 38.2 ± 0.5%, in 2a -46.1 ± 1.6%, (p <0.005), SaO2, respectively, in 1a -85.1 ± 5% and in 2a 89.6 ± 1.4% (p <0.05), which is typical for the increase in bronchial obstruction. When conducting EchoCG, there was a significant increase in DT and IRT, and the E / A ratio was 0.93 ± 0.04 (p <0.05 compared with 1.61 ± 0.02 KG). Analysis of VAL indicators in the dynamics of treatment showed a significant increase in indicators in the II and III groups of patients (Table 1)  In our study, the use of nebivolol on the background of BT in patients with BA with PH led not only to a decrease in PAPmn, but was also accompanied by a positive shift in pulmonary hemodynamics, DF RV ( Figure 1). After complex treatment, IRT decreased in the II and III groups of patients, respectively, by 10.5% (p <0.01) and 5.1% (p <0.05). PAPmn after treatment in the II-nd and III-nd groups in patients decreased respectively 15.7 and 9.5%, the reliability of the difference with the Figure 1 before treatment (p <0.05).

Discussion
The decrease in the indices of filling in the early diastole found by us should be explained by the disturbance of relaxation of the