MODERN CLINICAL AND FUNCTIONAL FEATURES OF CHRONIC LOWER RESPIRATORY DISEASES IN CHILDREN

Abstract

Chronic bronchitis (CB) and bronchial asthma (BA) are the most common chronic lung diseases in children. Despite the progress made in the diagnosis and treatment of these nosologies, which led to a decrease in the number of hospitalizations and deaths associated with it, CB and BA remain an urgent medical, social and economic problem in pediatrics. Determining the functional state of the respiratory organs in CB and BA is extremely necessary for the early diagnosis of pathological processes in the lungs, improving the treatment of patients, as well as an objective assessment of the condition of patients. Purpose of the study. To study the clinical and functional features of the course of chronic bronchitis and bronchial asthma in children. Materials and research methods. We examined 65 patients with atopic BA (group I) aged 3–16 years, and 45 patients with chronic bronchitis (group II). The control group consisted of 20 practically healthy children of the same age. The assessment of the function of external respiration (RF) in all groups was carried out using computer bronchophonography (CBFG). Results of the study and their discussion. In children of group I, 2 times more often than in group II, an unfavorable course of the antenatal and / or intranatal periods of development was noted (preeclampsia in the 1st and 2nd half of pregnancy, the threat of premature birth, ARI during pregnancy, exacerbation of chronic diseases, anemia in mothers). In children with a burdened allergic anamnesis, who had episodes of biofeedback at an early age and had a history of perinatal damage of hypoxic genesis of the 1st degree of severity, there is a more severe course and prolonged relief of acute bronchial obstruction, in connection with this, these children needed a more comprehensive examination of the functional parameters of the respiratory system. systems. Acoustic characteristics of breathing in children were determined after BFB relief, on the 6th-10th day of hospital stay. As a result of the analysis of the acoustic characteristics of breathing using computer bronchophonography (CBPH) in children with CB and BA, an increase in the level of the acoustic component of the work of breathing in the full frequency range (AKRD tot), AKRD in the mid-frequency (AKRD2) and high-frequency (AKRD3) ranges was noted. Conclusions. Children with CB and BA are characterized by changes in the functional parameters of the respiratory system, manifested by a high level of the acoustic component of the work of breathing in the full frequency range, indicating latent (in the absence of clinical manifestations) bronchial obstruction and the presence of bronchial hyperreactivity. At the same time, these changes in patients with a burdened allergic history were significantly more pronounced than in children without a burdened allergic history, which should be alarming regarding the early onset of bronchial asthma.