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.