Bodnarchuk V. Optimization of Diagnostic and Therapeutic Programmes of Uncontrolled Bronchial Asthma in Children

The present dissertation gives theoretical grounding and a new solving of actual task of modern pediatrics - improvement of indices of controlling bronchial asthma (BA) in children by improving a diagnostic algorythm and therapeutic tactics. Tested were 252 children aged from 6 to 18 years with persisting bronchial asthma of severe and moderate course who got inhalational glucocorticosteroids (IGCS) as a basic therapy. Objectiaely there were examined 140 out of 252 children who put up 2 clinical groups. The first (main) group included 70 children with uncontrolled course of disease while the comparing group included 70 patients with partial and completelycontrolled BA. The carried out investigations made it possible to find out factors influencing the BA controlling and to recommend a concrete algorythm of therapeutic tactics. The effectiveness of the latter was assessedon the ground of dynamic analysis of asthma - control test and spirometric investigation indices. In some patients (38 with uncontrolled and 30 with controlled BA) there were defined the level of antibodies IgG, IgA to Chlamydia pneumoniae, IgG, IgM to Mycoplasma pneumoniae and IgG to Toxocara canis and when needed there was prescribed a corresponding modification of a therapeutic complex. The use of the recommended diagnostic and therapevtic program made it possible to highly raise the indices of controlling BA and to provide its control in 82,86% patients.