Features of the course of chronic lung diseases in children at the present stage

Background. To date, the practice of clinical observations suggests that chronic bronchopulmonary diseases in children have undergone a significant transformation over the past 10 years. This is attributable to a better understanding of etiopathogenetic mechanisms, improvement of diagnostic methods, transformation of patient therapy using new genetically engineered drugs. Objective. Comparison of the course, the nature of functional changes, and the characteristics of the microbiota of the respiratory tract in children with various forms of chronic lung disease at the present stage. Methods. 98 children were examined during the research period. All patients were divided into two main groups. The first groupwas composed of children with primary chronic lung diseases (n=42): chronic (n=30) and obliterating bronchitis (n=12). The second group included children with lung diseases that developed either against the background of malformations (n=10) or due to a genetic mutation: cystic fibrosis (n=34), immunodeficiencies (n=12). Results. According to the data obtained, exacerbations were diagnosed significantly less frequently in patients of the second group than in the first ones. According to statistical analysis, moderate exacerbations prevailed in children of both subgroups. The main characteristic of the severity of exacerbations is respiratory failure. In patients with mendelian diseases, reactive changes in the pancreas and liver were significantly more likely to occur, while in primary chronic lung diseases, damage to the central nervous system were significantly more frequent. An analysis of the nature of the microbiota and the incidence of chronic carriage of gram-negative microflora revealed the leadership of patients of the second group. Conclusion. Thus, at the present stage, despite the fact that there is a more aggressive character of the microflora of the respiratory tract and a greater decrease in functional indicators in patients with a chronic bronchopulmonary process due to genetic mutations or malformations, the frequency and severity of exacerbations are inferior to those in patients with primary chronic lung diseases.

chronic lung diseases, chronic bronchitis, cystic fibrosis, immunodeficiencies, comorbid conditions, children