Цель работы-изучить состояние сердечно-сосудистой системы у детей школьного возраста в зависимости от уровня контроля бронхиальной астмы.

Objective. To study specific features of potassium metabolism and myocardial damage markers in the children with bronchial asthma, depending on the level of BA control. Materials and methods. Comprehensive examination was carried out in 189 children with persistent BA aged 6-17 years: group 1 consisted of 124 with uncontrolled course of the disease, group 2-30 patients with partially controlled BA and 35 patients with controlled BA. The comparison group consisted of 30 patients with controlled asthma without changes from the cardiovascular system. The unified flame photometry method with fluid analyzer FFA-1 was used to determine the erythrocyte potassium level. Total creatine phosphokinase level was estimated by UV-test. Creatine phosphokinase-MB level was determined by M-subunit immunoinhibition. Total lactic dehydrogenase-1 level was calculated by modified colorimetric method using an assay kit for colorimetric determination of total LDH. Serum LDH1 level was estimated by UV-method with the kit for determination of isoenzyme LDH1 activity. Results. In the children with UC BA serum K + and erythrocyte K + level was significantly lower compared to the children with PC BA, C BA, C BA with no changes in CVS and the control group. Total CPK and CPK-MB isoenzyme level in the children with UC BA, was significantly higher compared to those with PC BA, C BA, C BA without CVS changes and the control group. In the children with PC BA, total serum CPK level was also significantly higher compared to C BA (P = 0.007), C BA without CVS (P = 0.0002) changes and the control group (P = 0.001). Conclusion. Thus, the study demonstrated significant decrease of potassium level in blood serum and erythrocytes, twofold increase of total creatine phosphokinase and lactic dehydrogenase-1 isoenzyme levels, threefold increase in creatine phosphokinase-MB isoenzyme level, and one and a half time increase of total lactic dehydrogenase in the children with uncontrolled course of bronchial asthma.

У статті описаний вплив фармакотерапії інгаляційним глюкокортикостероїдом та бета 2-агоністом пролонгованої дії з похідним метилксантину тривалої дії на функціональний стан серцево-судинної системи при лікуванні неконтроольованої бронхіальної астми у дітей шкільного віку. Доведена кардіоваскулярна безпека будесоніду з формотеролу фумаратом в комплексі з доксофіліном та виявлений негативний вплив флютиказону пропіонату з сальметеролом в комплексі з доксофіліном на регуляцію ритму серця у даної категорії дітей.

Objective: to establish specific features of BA course in children with various phenotypes on the background of metabolic syndrome, depending on serum vitamin D 3 level.Subjects and methods. 106 children with BA participated in the study. 42 patients had BA associated with metabolic syndrome (MS), and 64 had BA with no MS. By the phenotype 61 (57.5 %) of patients had allergen-induced (allergic) asthma and 45 (42.5 %) -virus-induced (non-allergic) BA. The control group consisted of 44 children (the patients with MS and those without MS and BA), average age 15.5 ± 1.3 years. All the patients underwent a unified complex of diagnostic investigations: general physical examination, measurement of waist circumference and body mass index (BMI), clinical blood test, spirometry, lipid profile. Weight categories (normal weight, excess weight and obesity) were determined by percentiles (P) of BMI variation series with regard to age, as indicated in WHO recommendations. Serum 25(OH)D levels were determined by enzyme immunoassay. Vitamin D level ≥20 ng/ml was considered sufficient, 11-20 ng/ml -insufficient, ≤10 ng/ml -deficient. General and specific serum IgE levels were determined by enzyme immunoassay. The data obtained were processed with Statistica 8 program, P values of less than 0.05 were considered to indicate statistical significance.Results. In the group of patients with vitamin D 3 level below 20 ng/ml, 19.5 % had controlled BA and 41.3 % -uncontrolled BA, while among the children with vitamin D 3 level over 20 ng/ml, 30.4 % had controlled BA and 8.6 % -uncontrolled BA (χ 2 = 9.12, P < 0.05). Mean value of vitamin D 3 concentration in the control group was significantly higher than in the patients with BA associated with MS and BA without MS (P < 0.05). The relationship between OW, obesity and atopy was confirmed by high serum level of sIgE antibodies in those weight categories. High sIgE levels to allergens from the pollen of meadow grass, weeds and trees, animal epithelium, household dust mite, food and fungal allergens were determined much more frequently in the children with OW and obesity than in those with NW. In the patients with BA associated with MS and vitamin D 3 level below 20 ng/ml, FEV1 and FVLC values appeared to be significantly lower as compared to those with vitamin D 3 level over 20 ng/ml (P = 0.002). Inverse relationship between the most important parameters of external respiration function and BMI was established: VLC (r xy = -0.45, P = 0.002), FVLC (r xy = -0.52, P = 0.001), FEV1 (r xy = -0.78, P = 0.001), respectively. Conclusions.The severity of BA as well as the degree of its control in the patients with different phenotypes was found to be influenced by both the presence of MS and vitamin D 3 level. Therefore, vitamin D deficiency can be one of the risk factors of BA and MS development, and can affect the severity of both BA and MS course. Vitamin D 3 deficiency and the presence of MS greatly influence FEV1, FVLC, PEF values, decreasing the indices of external respiration in children and l...

Introduction: The problem of psycho-emotional state of patients with asthma is of great importance from a mental and social point of view. The aim: To find out the factors which influence mental state of adolescents, to determine features of clinical manifestations and of mental status in patients with bronchial asthma, depending on degree of its control. Materials and methods: 108 adolescents aged 11-17, ill with BA, of various levels of control. Luscher color test was used to determine the child’s mental status. Anxiety score was assessed by Spielberger-Hanin State-Trait Anxiety Inventory. Depressive status and depression severity were evaluated by HDRS. Results: The patients with UC BA reported unsatisfactory living conditions significantly more often compared to those with C BA and the children with PC BA compared to those with C BA (р<0.01). Patients with PC BA and UC BA were found to have significantly increased proneness to conflict, marked emotional tension and lability, mood swings, increased anxiety, vulnerability and sensitivity, as compared to those with C BA. Significantly lower state anxiety was revealed in the patients with C BA as compared to those with PC BA (p = 0.004) and UC BA (p = 0.0001). Significantly lower mean values of depression values were detected in the patients with C BA compared to those with UC BA (p=0.011) and PC BA (p=0.0015). Conclusions: The major factors influencing the psychological status of adolescents were: unsatisfactory living conditions, psychic and physical punishment, stress, heavy workload etc. The patients with BA developed psychological disorders under the influence of those factors.