The paper contains structure analysis of the lower respiratory tract recurrent disease in 180 children aged one to five years, residents of Odessa, who were treated in pulmonology department of Children’s Academician BJ Reznik City Clinical Hospital. The examinees are represented by two groups: 150 children with recurrent wheezing and 30 - with recurrent pneumonia. The selection criteria were: abnormality of central nervous system, abnormality, cystic fibrosis, congenital heart defects, tuberculosis, human immunodeficiency virus-infection. The analysis detected that in the survey sample with recurrent lower respiratory tract disease 3.88% of children had Orphan disease. Thus in the group of children with recurrent wheezing were diagnosed 2 cases of congenital lobar hyperexpansion (ORPHA 1928), one case of lung bronchogenic cyst (ORPHA 2357), one case of pulmonary hypoplasia in the lower lobe of the left lung (ORPHA 2257), and one case of primary ciliary dyskinesia (ORPHA 98,861). Regarding the entire structure of recurrent wheezing, most frequently was detected atopic asthma (49.33%). In 24.6% cases the cause of recurrent wheezing was associated with the otolaryngological pathology. Bronchopulmonary dysplasia was diagnosed in two children. Recurrent pneumonia cases were differentiated if the localization of process was at the same or different places. When one-sided localization of pneumonia was established, next congenital airway malformations were diagnosed - 3 cases of congenital cystic adenomatoid malformations (type I). Genetic pathology often occurred in cases with different lesions location. In all cases of uncertain diagnosis, predictors of recurrent lower respiratory tract diseases were revealed.

Pneumonia is one of the most severe respiratory pathology forms in children, which contributes significantly to infant mortality. The high risk of chronic bronchopulmonary process and child`s disability, in case of severe and complicated disease, requires careful pathophysiological change's analysis in community-acquired pneumonia (CAP) in children. In particular, for the prediction of these disorders in children with CAP are important the dysmetabolic phenomena study and the specific approaches development. The immediate aim of this work is to study the cellular energy metabolism (CEM) features and to develop approaches for the early bioenergetic disorders diagnostics in conditions of community-acquired pneumonia in adolescents.The aim of the study is to develop approaches for the early diagnosis of shifts in energy metabolism in children aged 14-18 years with CAP. An examination of 41 children aged 14-16 years with the definition of CEM indicators was conducted in order to develop an approach for predicting CEM disorders in community-acquired pneumonia using the method of logistic regression. A logistic regression method was used to develop a method for predicting CEM disorders in children with CAP. The characteristics of CEM in children with CAP were determined. A decrease in the succinate dehydrogenase activity and an increase in the lactate dehydrogenase / succinate dehydrogenase ratio in children with CAP relative to the reference parameters were observed, which indicated an inhibition of the anaerobic energy synthesis pathway. Two mathematical models for predicting CEM disorders in CAP based on logistic regression equations were proposed. The first mathematical model consisted of social and health characteristics and of pneumonia clinical course characteristics. In ROC analysis the area under the curve (AUC) was 0.82, diagnostic specificity – 71%, diagnostic sensitivity – 90%. The second model included only hematological parameters, AUC – 0.78, diagnostic specificity – 69%, diagnostic sensitivity – 81%. Thus, changes in CEM in children with CAP aged 14 – 18 years have been established. Two methods for predicting disorders of CEM in children with CAP have been developed, which can be applied to optimize the treatment of children with CAP aged 14-18 years.

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