SEVERE ASTHMA IN CHILDREN

The definition of severe asthma is based on the criteria for clinical control, the treatment received, as well as the response to therapy, the assessment of future risk. In severe bronchial asthma, control can be achieved only at the highest possible level of therapy, namely, in treatment corresponding to the 4th or 5th stage. The article highlights the features of the clinical phenotype of severe bronchial asthma in children. Purpose: to identify the predictors of severe phenotype in children, the analysis of clinical and anamnestic features, to study the dynamics of disease control. Materials and methods: a group of patients with different degrees of severity of bronchial asthma aged 3 to 12 years, both sexes, was studied. The clinical aspects of the disease, the dynamics of control over bronchial asthma have been studied. Functional tests were carried out: examination of the function of external respiration, pyclofometry. Data of a specific allergic diagnosis (skin tests with non-bacterial allergens, detection of specific IgE antibodies), self-monitoring tests were studied. Statistical methods used a nonparametric method, a c2 distribution, a Pearson test, using conjugacy tables. Results and discussion: the family female phenotype is a predictor of severe bronchial asthma in patients in this group. The severity of the disease on the background of therapy for five years in a group of patients was revised only in a third of children. With this phenotype, partial control over the disease was achieved. The ineffectiveness of control is associated with the presence of a comorbid background: the pathology of the nervous system, the gastrointestinal tract, endocrine disorders. The severe phenotype of bronchial asthma, independently of age debut, was significantly less frequent than in the case of moderate disease

ASSOCIATION OF CC16 POLYMORPHISM WITH RISK FACTORS OF FORMATION OF BRONCHO-OBSTRUCTIVE SYNDROME IN CHILDREN

Syndrome of bronchial obstruction is a symptomatic complex arising on the background of constriction or occlusion of bronchial tubes of different caliber due to bronchospasm, edema and inflammation of the bronchial mucosa, hypersecretion of mucus or compression by surrounding structures. Bronchoobstructive syndrome (BOS) is one of the most common pathological conditions in pediatric practice. The outcome of BOS can be different: from the complete disappearance of clinical manifestations to the process, disability or even death. Accordingly, the study of this problem and the search for methods for early diagnosis and prediction of the outcome of BOS is a very urgent problem. In order to identify risk factors for BOS and to clarify the association with polymorphism of the CC16 gene, 126 children belonging to the main group and 58 from the comparison group were examined. In the course of the study, the triggers influence on the formation of the BOS of concomitant ENT pathology, burdened personal and family allergic anamnesis, and also the recurrent nature of respiratory infections in the first year of life was proved. The association of polymorphism of AA gene of CC16 with the presence of weighed allergic anamnesis and frequent episodes of ARVI, as well as the influence of this genotype on the early debut of respiratory diseases in children, has been revealed. The relationship of the GG genotype with the concomitant ENT pathology among patients with recurrent BOS has been proved