FEATURES OF BRONCHIAL ASTHMA CONTROL AND COURSE IN CHILDREN WITH AN ALTERNATIVE ONSET OF THE DISEASE

Abstract

Introduction. Despite the large number of studies on the diagnosis and treatment of asthma and the constant updating of recommendations for the provision of medical care to patients with asthma, this disease still has a significant impact on the quality of life of patients and their families and significant economic losses. However, the peculiarities of bronchial asthma and the diagnosis of certain phenotypes of the disease in children, depending on biomarkers of inflammatory activity in the airways, require greater use of non-invasive diagnostic procedures and optimization of individualized treatment depending on the nature and intensity of inflammation in the respiratory tract.

Materials and methods. To study the peculiarities and control of bronchial asthma in children, depending on the alternative onset of the disease, on the basis of Regional Children's Clinical Hospital method "experiment-control" in parallel groups using a simple random of 319 children. In 257 children (clinical group I) bronchial asthma developed on the background of chronic obstructive bronchitis, clinical group II included 43 children in whom asthma debuted after community-acquired pneumonia, and the third (third) clinical group consisted of 19 children in whom asthma was verified after inpatient treatment for asthmatic status.

Discussion. It was shown that the representatives of the III clinical group, compared with other patients, more often had the phenotype of early asthma and severe disease, and the ratio of the chances of severe asthma in the future for these children compared with the cohort of group I was 6.8. It was found that among the children of the III clinical group according to all questionnaires, the patients with partially controlled and uncontrolled asthma prevailed, comorbid pathology in the form of allergic rhinitis and atopic dermatitis occurred more often, and allergic rhinitis was more severe than other cohorts of patients. According to the results of non-invasive studies, it was noted that the most active inflammatory process occurred in patients of groups II and III, which indicates the possibility of using these biomarkers to monitor the content of the inflammatory process in the respiratory tract.