Kravtsova O. Control of treatment of bronchial asthma with different phenotypes in children

Object of study: persistent bronchial asthma (BA); goal – to improve the control of bronchial asthma with different phenotypes in children by studying the level of adaptive capacity of the body, dysregulatory changes in the tone of the autonomic nervous system, somatotype differences and determine the functional features of the disease; research methods: general clinical, laboratory, anthropometric, instrumental, questionnaire, mathematical, statistical; novelty: the main causes of uncontrolled asthma in children are identified; extended scientific data on different phenotypic characteristics in children with uncontrolled asthma; it was found that vagotonia (chi-squared = 30,4, p < 0,001) and maladaptation (χ2 = 8,18, p < 0,01) are risk factors for uncontrolled disease; updated scientific data on the informativeness of FER indicators – MEF75, MEF50, MEF25 for the assessment of asthma control in children; found that in uncontrolled asthma on the background of standard basic therapy there are low levels of MEF75, MEF50, MEF25 and their high increase after inhalation with salbutamol, while the value of FEV1 remains ≥ 80 %, and its increase < 12 %; confirmed significance and informativeness of the increase in MEF75, MEF50, MEF25 in the sample with salbutamol, and their registration before the increase in FEV1 > 12 % is regarded as a marker of latent bronchial hyperresponsiveness in children with uncontrolled asthma; established additional functional criteria for determining the control of asthma in children when assessing the indicators of FER after a test with a bronchodilator – an increase in MEF25 and an increase in MEF50; it was found that the combination of an increase in FEV1 in the range of 6-11,9 % with an increase in MEF25 ≥ 25 % and/or MEF50 ≥ 22 % indicates a lack of asthma control; it is scientifically substantiated that in children with asthma in the test for reversibility of bronchial obstruction can be used formoterol fumarate, certain indications for its use; optimized monitoring of asthma control in children by supplementing the determination of the level of disease control (ACT and ACQ questionnaires) with quality of life assessment (PAQLQ questionnaire), which significantly increases the detection of uncontrolled asthma in children from 76,7 % to 97,8 % (chi-squared = 11,34, p = 0,01). Field of application – medicine.