SOVREMENNAYA PEDIATRIYA.2019.2(98):41-45; doi 10.15574/SP.2019.98.41

Koloskova О. К., Shakhova О. О., Tarnavska S. І., Manilich І. О.
HSEE «Bukovinian State Medical University», Chernivtsi, Ukraine
Municipal Establishment «Regional Children Clinical Hospital», Chernivtsi, Ukraine

Objective: to assess parameters of nonspecific bronchial reactivity in teenagers during attack-free period of bronchial asthma according to the results of a dynamic observation for many years.

Materials and methods. Nonspecific hypersuscpetibility of the bronchi was determined in 42 teenagers suffering from bronchial asthma (BA). Examinations were conducted in the period between attacks, when clinical signs of bronchial obstruction were completely absent and medicines able to affect the accuracy of nonspecific hypersusceptibility to direct and indirect stimuli were cancelled. The majority of children were repeatedly examined in the dynamics of observation.

Results. Bronchial hypersusceptibility was found to be lower in case of moderate course of bronchial asthma than in case of its severe variant, and constituted (threshold concentration 20 g) 1.58±0.5 mg/ml against 1.04±0.4 mg/ml. Bronchial reactivity according to the data of the dose-dependent curve was 2.01±0.14 standard units against 2.19±0.12 standard units respectively, which was indicative of a higher degree of the respiratory tract reactivity in case of severe course of the disease among teenagers. As far as severity of the disease among teenagers intensifies, bronchial liability indices (BLIs) increase. Thus, in case of a mild course of the disease BLI is equal 9.26±0.13% (95% CІ:0.12–1.45), in case of a moderate one — 13.18±3.93% (95% CІ:12.9–25.3), and severe course of BA — 27.7±4.2% (95% CІ:12.8–26.1), (Р<0.05). With a moderate variant BLI increases mainly at the expense of bronchodilation index 10.37±3.18% (95% CІ:10.5–20.5), with severe variant — at the expense of occurrence of physical strain bronchial spasm 12.3±3.34% (95% CІ: 9.5–20.4).

Conclusion. Hypersuscpetibility of the respiratory tract to direct and indirect stimuli during the period between attacks is likely to combine similar mechanisms, first of all including inflammation of the respiratory tract. Moreover, nonspecific bronchial hypersuscpetibility in teenagers should be considered as a multifactorial phenomenon, and rather epiphenomenon of bronchial asthma.

Key words: bronchial asthma, teenagers, hypersuscpetibility of the respiratory tract.

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Article received: Nov 07, 2018. Accepted for publication: Mar 05, 2019.