2021 , Vol.39 , No.13
84
Features of physical development of preschool
children with allergic diseases
Marifat
Devorova
Karataeva
1
.
Munira
Shaikhova
1
.
Dilbar
Mavlyanova
1
. and
Zulaykha
Kutlumuratova
1
’ Tashkent Pediatric Medical Institute, 223, Bogishamol Str., 100140, Tashkent, Uzbekistan
https://doi.org/10.5281/zenodo.5576583
Abstract.
Physical development is one of the main indicators of the health of
the child population. Based on the results of studies of indicators of physical
development, it is possible to obtain objective and reliable information about
the state of health of children. If these studies are carried out in dynamics, then
it is possible to make a scientifically grounded forecast regarding the state of
health of children in the future.This information is of great scientific and
practical importance for theoretical and practical medicine. The scientific
significance of research devoted to the problem of physical development has
especially increased in recent years. The fact is that the acceleration process,
according to the literature of recent years, has significantly slowed down or even
stopped. In this regard, it is necessary in new studies to clarify other aspects of
this problem: Comprehensive study of the epidemiology of allergy in children.
Clarification of the degree of influence of environmental factors on the physical
development and health of children.Social and hygienic living conditions have
a significant impact on the indicators of physical development and health status
of children.Detemiination of the relationship between the interdependence of
physical development and functional reserves of the div. Elucidation of the
nature of the influence of various diseases on the physical development and
health of children.
1 Introduction
Hie state of physical development of children suffering from allergic rhinoconjunctivitis. To
identify persons suffering from allergic rhinoconjunctivitis (ARC), children living in the
Yunusabad district of Tashkent city were examined and examined. After a thorough clinical
and allergic examination. 58 children with ARK were selected for further observation and
research. The age of patients varied from 3 to 6 years, including at the age of 3 years - 16
(27.6%), 5 years - 13 (22.4%). 6 years - 14 (24.1%). Among the selected children, there were
33 boys (56.9%), and 25 girls (43.1%). The number of children in age groups and the ratio of
boys and girls were approximately the same (Table 1.1).
* Corresponding author:
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Our studies have shown that the predominant symptoms in sick children were diffuse
itching, burning in the nose and nasopharynx, rhinorrhea and paroxysmal sneezing, poor sleep,
irritability, difficulty breathing through the nose, and general weakness.
Table 1.1.
Distribution of children with ARC by sex and age (n = 58).
Age. years
number of observed children
Boys
Girls
Both sexes
abs
%
abs
%
abs
%
3
9
15.5
7
12.1
16
27.6
4
8
13.8
7
12.1
15
25.9
5
8
13.8
5
8.6
13
22.9
6
8
13.8
6
10.3
14
24.1
Total:
33
56.9-+6.5
25
43.1-+6.5
58
100.0
Examination of the nose showed swelling of the mucous membrane. Tire color of the mucous
membrane was white, blue or gray. Nasal discharge was mucous, serous. Tire disease was
clearly seasonal. Exacerbation of symptoms was often noted during the springsummer or
summer-fall season. Tire duration or duration of the disease ranged from several months to 5
years or more (Table 1.2).
Table 1.2.
Duration (duration) of illness in children with ARK (n = 58).
Duration of
illness
number of observed children
Boys
Girls
Both sexes
abs
%
abs
%
abs
%
Up to 2 years
15
25.9
13
22.4
28
48.3-+6.6
3-5 years old
10
17.2
8
13.8
18
Г
31.0-+6.1
Over 5 years
8
13.8
4
6.9
12
20.7-+5.3
Total:
33
56.9
25
43.1
58
100.0
Tire analysis showed that the duration of the disease up to 2 years was in 28 (48.3%) patients,
from 3 to 5 years - in 18 (31.0%), over 5 years - in 12 (20.7‘lt/). Consequently, the vast majority
of 46 (79.3%) patients suffered for a long period. This, naturally, negatively affected the growth
and development and other indicators of children's health.
It is of interest to analyze the results regarding the age of children at which the first
symptoms of the underlying disease appeared. In most patients, the first symptoms of the
underlying disease appeared at the age of 2-3 years - 33 (56.9%), which indicates that many
patients suffered from ARC for a long period of time (Table 1.3).
Table 1.3.
Age of children at which the first symptoms of ARC appeared (n = 58).
Age, years
number of observed children
Boys
Girls
Both sexes
abs
%
abs
%
abs
%
2-3
12
20.7
21
36.2
33
56.9-+6.5
4-5
10
17.2
15
25.9
25
43.1-+6.5
Total:
22
37.9
36
62.1
58
100.0
Literary data indicate that in recent years, cases of combined forms of allergy have become
more frequent. Our data also showed that ARA was often combined with other allergic
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reactions. Hie most frequent combination was with dmg allergy - in 24 (41.4%), atopic
dermatitis - in 20 (34.5%) and food allergy - in 14 (24.1%) (Table 1.4). Combined forms of
allergy are distinguished by their chronic course, frequent exacerbations.
Table 1.4.
Distribution of children with ARC by sex and age (n = 58).
Allergies
combined
Frequency combinations
Boys
Girls
Both sexes
abs
%
abs
%
abs
%
Medicinal
12
20.7
12
20.7
24
41.4-+6.5
Atopic dennatitis
12
20.7
8
13.8
20
34.5-+6.2
Food
9
15.5
5
8.6
14
24.1-+5.6
Total:
33
56.9
25
43.1
58
100.0
In the mechanism of the formation and development of allergic diseases, including ARA, risk
factors are essential. According to our data (Table 1.5), in general, genetic factors occurred in
36 (62.0%) patients, allergic diathesis - in 45 j-77.6%), focal infections - in 43 (74.1%), artificial
feeding in the first year of life - in 47 (81.0%).
Table 1.5.
Hie incidence of risk factors in the development of ARC in children (n = 58).
Occurrence factors
risk
Frequency combinations
Boys
Girls
Both sexes
abs
%
abs
%
abs
%
Genetic
20
34.5
16
27.6
36
62.1-+6.4
Allergic diathesis
25
43.1
2&Й.
34.5
45
77.6-+5.5
Focal infections
24
41.1
19
. 32.8
43
74.1-+5.7
Artificial feeding
28
48.3
19
32.8
47
81.0-+5.1
Ure study of physical parameters (length of height, div weight and chest circumference)
showed the following results (Table 1.6, Figure 1.1, Figure 1.2 andFigure 1.3). to judge the
shifts in anthropometric indicators under the influence of various risk factors and the allergic
process, we carried out a comparative analysis of them with the ready-made standards for the
physical development of children in the Tashkent region, developed by other scientific
institutions of the country.
When comparing anthropo metric indicators with the standards developed by the Research
Institute of Pediatrics, children with ARC showed a significant (PTO.OOl) lag in physical
growth and development. So, growth rates were lower than similar indicators of the standard
(Table 1.7) for boys by 7.7-17.9%, and for girls - by 7.3-11.5% (Figure 1.1). Body mass
indicators were lower than similar indicators of the standard for boys by 16.027.9%, and for
girls - by 15.1-26.4% (Fig. 1.2). Ure chest circumference indicators were 2.4-4.1% lower than
those of the standard for boys, and 2.0-3.3% for girls (Figure 1.3).
Table 1.6.
Indicators of physical development of children with ARC (n = 58).
Age, years, gender
Body length (cm)
Body weight (kg)
Chest circumference
(cm)
3
Boys
85.1-+49***
12.5-+0.37***
50.8-+0.40***
Girls
82.3-+3.39**
12.6-+0.21***
50.7-+0.18***
4
Boys
87.8-+2.64***
12.9-+0.53***
53.1-+0.30**
Girls
86.1-+2.79***
12.9-+0.57**
52.7-+0.18***
5
Boys
103.1 +1.62***
14.7-+0.36***
53.8-+0.30**
Girls
98.8-+1.46***
15.0-+0.71**
54.8-+0.20***
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6
Boys
97.5-+3.39***
15.9-+0.47***
54.2-+0.25***
Girls
102.3-+2.58***
16.3-+0.98**
56.4-+0.33**
Note: * - reliable in comparison with the data of practically healthy children (* -P <0.05; ** - P <0.01;
*** -P <0.001)
Table 1.7.
Indicators of physical development in practically healthy children (according to the
________________________________ standard). ________________________________
Age, years, gender
Body length (cm)
Body weight (kg)
Chest circumference
(cm)
3
Boys
92.8+0.06
14.5-+0.2
52.9-+0.4
Girls
91.8-+0.08
14.5-+0.08
52.0-+0.08
4
Boys
98.0-+0.08
16.5-+0.2
54.4-+0.4
Girls
96.0-+0.08
16.3-+0.9
54.0-+0.08
5
Boys
111.0-+0.08
18.2-+0.18
55.5-+0.4
Girls
106.0-+0.08
18.0-+0.8
56.0-+0.08
6
Boys
115.0-+0.08
19.8-+0.19
56.0-+0.4
Girls
114.0-+0.08
20.0-+0.8
57.5-+0.08
■
boys
■
girls
Fig. 1.1.
Average indicators of growth retardation in children with ARC (n = 58).
16
14
12
10
8
6
4
2
0
Fig. 2.1.
Average indices of lag in the development of div weight in children with ARC (n = 58).
15,1
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Fig. 3.1.
Average indices of developmental lag in the chest circumference in children with ARC (n =
58).
2 Materials and methods
The object of the study was children attending kindergartens and schoolchildren living in the
conditions of Tashkent. There were 205 sick children of preschool age (3 -6 years old) under
observation: boys-117, girls-88; 271 children of school age dj-14): boys - 141 (52.0%), girls -
130 (48.0%) and 50 practically healthy children of the corresponding age and gender. Preschool
children attended one of the kindergartens in the Yunusabad district and school-age children
studied in schools in the same district of Tashkent. Children have permanently lived in the city
of Tashkent for at least 5 years.
Determination of the main anthropo metric parameters of the div
Tire main anthropo metric parameters of the div (div length and weight, chest
circumference) were determined by measuring them in a generally accepted way. Tire
assessment of the physical development of the examined sick children was carried out in
comparison with similar indicators of physical development obtained in practically healthy
(control 1) and with the standards of indicators of the physical development of children
permanently residing in the regional conditions of the Tashkent region (control 2).
Specific diagnosis of allergies in children
Specific diagnostics of allergic diseases was established on the basis of a comprehensive
clinical-allergic, functional, laboratory examination of patients and the setting of specific
allergic diagnostic tests (in vivo), taking into account the International Consensus.
When collecting an allergic anamnesis, attention was paid to the history of the development
of the main and concomitant diseases, the presence of a connection between the symptoms of
the disease and the intake of certain medications. We found out the presence of allergic diseases
in the closest relatives (mother, father, grandmother, grandfather), that is, hereditary burden.
The state of health of the mother of a sick child during pregnancy (toxicosis, pathological
childbirth, etc.) and the nature of the child's nutrition in the first year of life after birth (natural,
artificial, previously mixed) were clarified. We found out and took into account the peculiarities
of the child's reaction to preventive vaccinations, as well as the living conditions of sick
children.
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Hie diagnosis of allergic rhinitis (AR) was made on the basis of modem criteria set forth in
the European International Competition (2000) on AR with the advice of an
otorhinolaryngologist.
Hie diagnosis of bronchial asthma (BA) was made according to the recommendations of
the National Institute "Heart, Lungs. Blood" WHO and the national program "Treatment and
prevention of bronchial asthma in children and adults of the Ministry of Health of the Republic
of Uzbekistan"
Hie diagnosis of atopic dermatitis (AD) was made with the advice of a specialist
dermatologist in accordance with the criteria generally accepted in modem dermatology (12):
itching of the skin, typical morphology and localization of skin rashes, chronic recurrent course,
atopy in history or hereditary predisposition to atopy eosinophilia of the blood.
Hie diagnosis of allergy of the gastrointestinal tract (GIT) was made with the advice of a
specialist gastroenterologist, using the Sydney classification. Hie presence of gastrointestinal
allergy was determined on the basis of the presence of hyperacidity of the stomach, hyperergic
reactivity of parietal cells of the stomach, hyperduokinesia.
Allergy skin tests
When setting allergic skin tests, all the necessary precautions were observed: taking into
account indications and contraindications, the need to set two controls (saline or extracting
liquid and histamine), the presence of a set of anti-allergic and anti-shock drugs, etc. Skin
allergic tests were given to school-age children.
Hie results of allergic reactions were assessed in a generally accepted way (tables 2.1 and
2.2).
Table 2.1.
Scheme for recording scarification allergic reactions.
No
Skin appearance and blister size
Assessment of reactions
1
Hyperemia, no blister
Ne
A
Ative-|*v
2
Hyperemia, no edema at the site of scarification
Doubtful (_ +)
3
Hyperemia, blister 2-3 mm
W eakly po sitivfif+j
4
Hyperemia, blister 4-5 mm
Positive (++)
5
Hyperemia, blister 6-10 nmi
Strong positive (+++)
6
Hyperemia, blister more than 10 mm with
pseudopodia
VetT. sharp degree of positive reaction
(++++)
Table 2.2.
Scheme for recording intradermal allergic reactions.
No
Skin appearance and blister size
Assessment of reactions
1
Skin reaction is the same as in control
Negative (-)
2
Hie blister dissolves more slowly than control
Doubtful (_ +)
3
Blister 4-8 mm surrounded by erythema
Weakly positive (+)
4
Blister 8-12 mm surrounded by erythema
Positive (++)
5
Blister 12-18 mm surrounded by erythema
Strong positive (+++)
6
Blister more than 18 mm with pseudopodia,
additional blisters around the periphery and bright
Very sharp degree of positive reaction
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erythema
3 Functional research methods
A peakfluometer was used to determine bronchial patency. Peakfluometer readings are
determined in 1 / s.
4 Laboratory research methods
General analysis of blood, urine, feces and sputum of the patient was carried out by generally
accepted methods. Statistical processing of the obtained data.
The obtained data were subjected to statistical processing on a personal Pentium-4 using
programs developed in the EXCEL package, using a library of statistical functions, with the
calculation of the arithmetic mean (M), standard deviation, standard error (m), relative values
(frequency.%). Student's test (t) with the calculation of the error probability (P). Differences in
mean values were considered significant at a significance level of P> 0.05. At the same time,
the existing guidelines for the statistical processing of data from clinical and laboratory studies
were adhered to. Amount of work performed
Table 2.3.
Amount of work performed.
No
The nature of the work
number
1
Clinical and allergological examination of preschool children suffering from:
- allergic rhinoconjunctivitis
58
- allergic recurrent obstructive bronchitis
50
-bronchial asthma
32
- gastrointestinal allergy
65
2
Clinical and allergological examination of school-age children suffering from:
- allergic rhinoconjunctivitis
114
- allergic recurrent obstructive bronchitis
84
-bronchial asthma
73
3
Determination of the parameters of the physical development of preschool children
suffering from:
-respiratory allergies
140
- gastrointestinal allergy
65
4
Determination of the parameters of the physical development of school-age
children suffering from:
- allergic rhinoconjunctivitis
114
- allergic recurrent obstructive bronchitis
84
-bronchial asthma
73
5
Determination of specific allergic reactivity in schoolchildren with respiratory
allergies:
-determination of the frequency of positive reactions to regional non-infectious
allergens (pollen, dust, epidermal, insect)
271
-determination of the severity (intensity) of the inflammatory reaction of the skin
to non-infectious allergens
271
- determination of indicators of allergometric titration for regional allergens
271
5 Results
(++++)
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Hie reason for the lag in the physical development of preschool children is obviously associated
with the negative impact of ARC on their health. According to the anamnesis, the first
symptoms of the disease in sick children appeared at the age of 3 -4 years, the disease often
acquired a chronic course. Risk factors were also of significant importance: hereditary burden,
artificial or previously mixed feeding in the first year of a child's life, the presence of chronic
focal infections, as well as the pathology of pregnancy of mothers of sick children. It is
impossible to exclude the development of polysensitization and the frequent combination of the
underlying disease with other allergic reactions and diseases.
6 Discussions
Ulus, conducting a comprehensive clinical, allergic examination of 58 sick preschool children
suffering from allergic rhinoconjunctivitis, determining some parameters of the physical
development of children, the following facts were established:
In children suffering from allergic rhinoconjunctivitis, there is a lag in physical
development, which manifests itself in the presence of a deficit in div length and weight, as
well as chest circumference.
Allergic rliinoconjunctivitis, which lasts for a long time and negatively affects the health of
children, plays a significant role in the complex of reasons that are important in the lag in the
physical development of preschool children. To ensure the normal development of the physical
parameters of preschool children in the complex of measures, it is necessary to include the
timely recognition and treatment of allergic diseases in general and allergic rliinoconjunctivitis
in particular.
7 Conclusion
Analysis of modem literature has shown that the problems of the influence of various exogenous
and endogenous factors on the physical development of children are being intensively studied
by researchers from various positions. However, the issues related to the influence of various
diseases, especially allergic ones, on the physical development of children are not sufficiently
covered in the literature. There is no scientifically substantiated information regarding the
peculiarities of allergies in children with different levels of physical development and living in
different environmental conditions. We have studied the issues of the negative impact of some
allergic diseases on the physical development of preschool and school children.
140 children aged 3-6 years were under observation, including 77 boys (55.0%), and 63
girls (45.0%). Children permanently lived in Tashkent, for at least 5 years, and attended one of
the kindergartens of the Yunusabad district of Tashkent. Ure clinical forms of manifestation of
respiratory allergies were different: allergic rliinoconjunctivitis - 58 (41.4%), allergic recurrent
obstructive bronchitis - 50 (35.7%), bronchial astluna - 32 (22.9%). Hie first symptoms of the
disease appeared in 2-3 years in the majority of patients - 80 (57.1%). Hie duration of illness in
the majority of patients - 82 (58.6 - + 4.1%) was within 5 years and more. One of the most
important features of allergic diseases is the combination of the underlying disease with other
allergic reactions and diseases. When analyzing the data, it turned out that the underlying
disease was combined with other allergic reactions and diseases with different frequencies: food
allergy - 60 (42.8%), atopic dermatitis - 47 (33.6%), drag allergy - 33 (23.6%).
Exogenous and endogenous risk factors were of great importance in the development of
allergic respiratory diseases. Among them, a special place was occupied by hereditary burden.
According to our data, genetic factors were important in 67.4% of cases. Hie
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predisposition to allergies was most often transmitted through the female line (76.4%).
Allergies were inherited less frequently in the male line (23.6%). Clinical forms of allergic
diseases in close relatives did not always coincide with allergies in children. Uris fact indicates
that it is not an allergic disease as such that is inherited, but the div's predisposition to allergies
in general. In addition, such risk factors as allergic diathesis (72.7%), focal infections (78.0%),
artificial and (or) previously mixed feeding (83.3%) were also important.
With regard to the influence of respiratory allergic diseases on the physical development of
preschool children, it was possible to find out the following.
In children with respiratory allergies, there was a significant (P <0.001) lag in height (div
length), div weight (weight) and chest circumference. So, in children of all studied age groups
(3-6 years old), both boys and children, there was a deficit in div length compared to similar
indicators of the standard, on average in boys by 8.2-13.8%, and in girls - by 9.0-15.1%.
underweight in boys - by 7.4-27.7%. and in girls - by 8.2-24.1%. chest deficit in boys - by 2.64.1
%, and for girls - by 2.7-4.9%.
Among the factors that negatively affect the physical development of children, great
importance is attached to the pathology of the digestive system In this regard, it was of certain
scientific and practical interest to determine the influence of gastrointestinal allergy (GIT) on
the physical development of preschool children.
65 sick children aged 3-6 years with AP of the gastrointestinal tract were under observation:
40 boys (61.5%), 25 girls (38.5%). It turned out that AP of the gastrointestinal tract is clinically
manifested in the form of chronic gastroduodenitis-29 (44.6%), dysfunction of the biliary tract
- 21 (32.3%), chronic gastritis -9 (13.8%), chronic enterocolitis-6 (9, 2%). Both in boys - 30
(46.2%), and in girls - 20 (30.7%), chronic gastroduodenitis and biliary dysfunction prevailed.
Tire duration of the illness ranged from several months to 6 years. In the majority of patients,
47 (66.1%), the duration of the disease ranged from 3 to 6 years, including in 25 (38.5%) boys
and 18 (27.7%) girls.
It turned out that the first symptoms of the disease appeared during the first 12 months of
life afterbirth in 44 (67.7%) patients.
Tire symptomatology of AP of the gastrointestinal tract was varied. Tire predominant
symptoms of AP of the gastrointestinal tract were: pain in the epigastric region - in 47 (72.3%)
patients, flatulence - in 33 (50.7%), etc.
Risk factors were of great importance in the formation of AP of the gastrointestinal tract.
Hereditary burden was observed in 40 (61.5%) patients. In most cases, heredity was aggravated
in the female line (mother, grandmothers) - 27 (67.5%), while in the male line (father,
grandfather) - in 13 (32.5%). Conscqucntln in the female line, the hereditary predisposition to
AP of the gastrointestinal tract was transmitted 2 times more often (P <0.05). Ure closest
relatives suffered from various allergic diseases. For example, the mother or father suffered
from bronchial asthma, hay fever, atopic dermatitis and other allergic diseases.
Among the risk factors, great importance is attached to the nature of the nutrition of children
in the first year of life. According to our data, artificial and (or) previously mixed feeding was
observed in 46 (70.8%) patients.
AP of the gastrointestinal tract was often combined with food allergy - in 18 (27.7%) and
atopic dermatitis - in 10 (15.4%), and less often with respiratory allergy and drug allergy - in 5
(7.7%) patients. In general, the combination of AP of the gastrointestinal tract with other
allergic reactions and diseases was 39 (60.0%) patients. A comparative analysis of our data with
similar literature data convincingly indicates the presence of features of the gastrointestinal tract
AP.
In practically healthy children 3-6 years of age, div length indicators were: for boys - 92.5
+ 0.56-118.2- + 0.60 cm and for girls - 90.0 + 0.93-115, 0- + 0.89 cm div weight
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for boys - 14.4- + 0.17-20.0- + 0.68 kg, and for girls - 14.3- + 0.33-19.6- + 0.56 kg, chest
circumference for boys - 50.9- + 0.48-55.7- + 0.21 cm, for girls - 52.6- + 0.51-56.9- + 0.30 cm
These indicators did not differ significantly (P> 0.05) from similar indicators of the standard
established for children (preschool age) living in the regional conditions of the Tashkent region.
In children (both boys and girls) suffering from AP of the gastrointestinal tract, a significant (P
<0.05%) deficit in growth (div length), div weight and chest circumference was observed.
In children with gastrointestinal tract AP, there is a growth deficit on average in boys of
8.2-
13.8%, and in girls - 9.0-15.1%. Ure div weight deficit averaged 7.4-27.7% in boys, and
8.2-
24.1% in girls. Hie chest circumference deficit averaged 2.6-4.1% in boys, and 2.74.9%
in girls.
There was a certain pattern associated with the age of the patients. Hie deficit in height and
div weight was minimal (8.2-9.0%) in children of 3 years of age and maximum (13.815.1%)
in children of 5 years. Hie breast circumference deficit was minimal (2.6-2.7%) and did not
depend on the age and gender of the children.
In the mechanism of occurrence of AP of the gastrointestinal tract, the development of
allergic inflammation on the surface of the mucous membrane of the gastrointestinal tract (GIT)
is of decisive importance, which leads to a significant violation of the secretory, absorption,
endocrine and evacuation functions of the gastrointestinal tract. It is impossible to exclude the
excessive action of hydrochloric acid, bile acids, pepsin, etc., which leads to the destruction of
the intestinal cytoprotection system, increased penetration of allergic structures into the internal
environment of the div.
After conducting a comprehensive clinical and allergic examination of 271 school-age
children (7-14 years old), among them 141 boys (52.0- + 3.0), 130 girls (48.0- + 3.0) suffering
from allergic rhinoconjunctivitis (31.0%), bronchial asthma (26.9%), established the features
of the clinical course of these diseases and determined their negative impact on the physical
development of the div.
According to our data, in the majority of patients - 148 (54.6%), the first symptoms of the
disease appeared at an early (2-6 years) age.
Hie main diseases in general were combined with other allergic reactions in 199 (71.4%)
cases. A frequent combination was observed with drug allergy - in 83 (30.6%), atopic dermatitis
- in 68 (25.1%) and food allergy - in 48 (17.7%) patients. Of the risk factors in general, genetic
factors were important in 197 (72.7%) patients, allergic diathesis -in 194 (71.6%), focal
infections - in 190 (71.6%), artificial feeding in the first year of life -in225 (83.0%).
As you know, there are predisposing, causal (sensitizing), contributing triggers that
exacerbate the symptoms of the underlying and concomitant diseases.
According to our data, the genetic predisposing factor was of decisive importance, since the
frequency of occurrence of this factor was in the range of 64.9-79.7%. Allergic diathesis (65.4-
74.5%), focal infections (65.8-75.3%), artificial feeding in the first year of a child's life (80.8-
84.5%) were also of significant importance.
In children with respiratory allergies, there was a noticeable lag in physical growth and
development.
So, growth rates (div length) were lower than similar indicators of the standard, on
average, for boys - by 8.2-13.8%, and for girls - by 9.0-15.1%. Body mass indicators were also
lower than similar indicators of the standard in boys - by 7.4-27.7%, and in girls - by 8.224.1%,
chest circuntference indicators in boys - by 2.6-4.1 %, and for girls - 2.7-4.9%.
Hie reason for the lag in the physical development of school-age children is obviously
associated with the negative impact of respiratory allergies on their general health. According
to the anamnesis, the first symptoms of the disease appeared at the age of 4-6 years. Hie disease
often became chronic. Hereditary burden, artificial and (or) previously
94
mixed feeding in the first year of a child's life, the presence of chronic focal infections, as well
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З?ФЛ2А|ЙА®Ф;А.2О21Т13Я ®39®1?13ИСН1п J Ind HygOccup Dis , 2021 , Vol.39 , No.13
as the pathology of pregnancy in mothers of sick children, polysensitization and frequent
combination of the underlying disease with other allergic reactions and diseases were of
significant importance in the development of the disease.
To study the effect of respiratory allergies on the physical development of school-age
children, 271 patients aged 7-14 years were under observation, including 141 boys (52.0%),
130 girls (49.0%). Hie children suffered from the main three clinical forms of respiratory
allergies: allergic rhinoconjunctivitis (42.1%). allergic recurrent obstructive bronchitis (31.0%),
bronchial asthma (26.9%). In the majority of patients - 148 (54.6%), the first symptoms of the
disease appeared at an early (2-6 years) age, the underlying disease as a whole was combined
with other allergic reactions in 199 (73.4%) cases. A frequent combination was observed with
drug allergy - in 83 (30.6%), atopic dermatitis - in 68 (25.1%) and food allergy - in 48 (17.7%)
patients. Tn the mechanism of the formation and development of allergic diseases, genetic
factors were of significant importance in 197 (72.7%) patients, allergic diathesis - in 194
(71.6%), focal infections - in 190 (71.6%), artificial feeding in the first year of life - in 225
(83,0%r Ure genetic factor was of decisive importance, since the frequency of occurrence of
this factor was in the range of 64.979.7%. Allergic diathesis (65.4 - + 5.1-74.5 - + 4.0%)t-focal
infections (65.8-75.3%), artificial feeding in the first year of a child's life (80.884.5%), which
is consistent with the literature data.
In our studies, growth rates were lower than similar indicators of the standard, on average,
for boys by 8.3-10.9%, and for girls - by 9.8-11.2%. Body mass indicators were lower than
similar indicators of the standard: for boys by 20.9-35.4%, and for girls - by 25.1-40.5%.
Indicators of chest circumference were lower than similar indicators of the standard: for boys
by 12.9-20.5%, and for girls - by 15.4-20.8%.
Respiratory allergies negatively affect the formation of the physical development of
children. According to the anamnesis, the first symptoms of the disease in children appeared at
the age of 4-6 years. Ure disease often became chronic.
In recent years, the theory of the reactivity of the organism has been widely developed.
Determination of the allergic reactivity of the patient's div is of great practical importance. In
this regard, there is a natural need for detailed studies related to clarification of the
characteristics of the div's allergic reactivity in various diseases.
A comparative analysis of the study of the specific allergic reactivity of the organism of
children suffering from different clinical forms of respiratory
A
allergies showed the following
results.
It turned out that the degree of increase in the specific allergic reactivity of the patient's
div depends on the clinical form of respiratory allergies and the type of specific allergens.
So, for example, the reactivity of the organism of children suffering from ARK and AROB
was the highest to allergens from pollen of wormwood (64.3-87.7%) and quinoa (53.6-72.8%).
Specific heightened reactivity in children with asthma to allergens from wormwood and quinoa
pollen (24.7-28.8%) was relatively low compared with the reactivity of patients with ARC and
AROB.
Consequently, in the etiology of respiratory allergies in children, allergens from grass pollen
were of significant importance as sensitizing factors.
Ure specific allergic reactivity of the children's organism to the allergen from house dust
largely depended on the clinical form of respiratory allergies. Ure highest specific
hypersensitivity of the organism was observed in children with BA (72.6%) and AROB
(71.4%). Ure specific allergic reactivity in children with ARK to house dust allergen was
relatively low (35.1%).
Hence, it is clear that in the etiology of AD and AROB in children, as a sensitizing factor,
the allergen from house dust is of primary importance.
95
Hie specific allergic reactivity of the organism in children suffering from respiratory
allergies to epidermal allergens, in comparison with pollen allergens, was significant (P <0.05)
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ЗзФЛ2А|КА®Ф;А.2021Т13Л ®39®1?13ИСН1п J Ind HygOccup Dis , 2021 , Vol.39 , No.13
2-3 times lower. Hie frequency of positive scarification tests did not depend on the clinical
forms of respiratory allergies and was in the range of 13.2-35.1%. In general, the patients'
allergic reactivity was relatively higher to the cat hair allergen than to the dog hair allergen.
To clarify the allergic reactivity of the organism to insect allergens, the most common house
dust mites D. Pteronyssinus and G. Cadaverum, most common in the region of Uzbekistan,
were used. Hie specific allergic reactivity of the organism of children with BA was significantly
(P <0.05) higher (63.0-65.8%) than the analogous reactivity of the organism in children with
ARC. AROB (31.6-39.3% ).
An analysis of the results of the severity of allergic inflammation of the skin in children
suffering from respiratory allergies also testifies to a high degree of allergic reactivity. Tn all
patients, reactions expressed by +++ and ++++ prevailed. So. for example, in children with
ARC, such reactions were found in 79.0%, with AROB - in 63.9%. BA - in 60.9% of cases.
Allergy titration indices reached high values and depended on the clinical forms of allergic
diseases and the type of allergens. Hrus. the indicators of allergometric titration reached 10-8
for pollen allergens with ARC. 10'
6
for house dust allergens. 10'
5
for epidermal allergens, and
10'
6
for insect allergens. Hie indicators of allergometric titration in patients with AROB for
pollen allergens - 10-8 and for allergen from house dust - 10'
7
. For epidermal and insect
allergens, respectively -10'
5
and 10'
6
.
In BA patients, the indices of allergometric titration reached 10'
8
for pollen allergens and
house dust allergens, and 10'
6
for epidermal and insect allergens.
Hrus. in all children suffering from respiratory allergies, the specific allergic reactivity was
increased, /dong with this, it was possible to identify some features of changes in the reactivity
of the div, depending on the clinical forms of respiratory allergies and the type of regional
allergens. With ARA. the patient's div was more susceptible to pollen allergens. However,
allergens from grass pollen played a significant role in the development of sensitization of the
organism Children with AROB were more susceptible to house dust allergen. In children with
asthma, the allergic reactivity of the div to the allergen from house dust and allergens from
house dust mites was 2-5 times higher than to pollen and epidermal ones. Hie intensity of
allergic skin inflammation in most patients is quite pronounced.
References
1.
I.I. Ryumina, M.M. Yakovleva, Rus med journal,
19(3),
146-149 (2011)
2.
M.M. Gubin, G.V. Azmetova, Pharmacy, 7, 40-48 (2008)
3.
O.S. Drobik, D.S. Fomina, L.A. Goryachkina, et al.. Allergology and immunology,
1,
3845
(2012)
’
4.
S.V. Morozova, Doctor, 9, 27-32 (2012)
5.
I.V. Nesterova, Attending physician, 6, 26-29 (2009)
6.
E.V. Nosulya, A.K. Vinnikov, I. A. Kim, Rus. honey, zhum..
19(8),
490-493 (2011)
7.
D.Y. Ovsyannikov, L.V. Pusliko,
Allergic rhinitis in children: teaching method.
manual for the study of the course "Children's diseases" (Publishing house of RUDN, M„
2012)
’
8.
I.V. Ozerskaya, N.A. Geppe, U.S. Malyavina, Attending physician, 9, 17-20 (2011)
9.
T.A. Filippova, A. S. Verba, New research, 4, 37 - 45 (2013)
96
10.
A.V. Suizhik. Pediatric Pharmacol 9(4), 106-110 (2012)
11.
N.P. Shabalov. Neonatology. M .: MEDpress - inform. 1, 640 (2019)
12.
G.I. Smirnova. R.E. Rumyantsev. Russian Pediatric Journal.
20(3),
1666-172 (2017)
DOI: 10.18821 / 1560-9561-2017-3-166-172.
13.
M.B. Devorova. Eurasian Union of Scientists. 7(3), (2015)
Ф
Л
З?ФЛ2Т|Й>®Ф;Ф.2О21Ф13Л ®39®l?13Schin J Ind HygOccup Dis , 2021 , Vol.39 , No.13
14.
T.I. Garashchenko, Terra Medica Nova,
2(2),
1014 (2009)
15.
N.A. Geppe, N.G. Kolosova, Consilium Medicum. Pediatrics (application), 3, 71-74
(2012)
16.
L.K. Goryainova, Polyclinic,
4(1),
52-57 (2011)
17.
M.B. Devorova. E.A. Shomansurova. Medicus. 2, 32-34 (2019)
18.
L.M. Anchieta, C.C. Xavier, E.A. Colosimo, J de Pediat.
80,
267-276 (2004)
19.
D. Zisi, A. Challa, A. Makis, Hormones,
18,
353-363 (2019) https:
//doi.org/10.1007/s42000-019-00155-z
20.
G.R. Zosky, P.H. Hart, A.J.O. Whitehouse, et al., Ann Am Thorac Soc.,
11(4),
571-577
(2014) doi: 10.1513 / AnnalsATS.201312-423OCpmid: 24601713.
21.
J. Tyrrell, R.C. Riclunond, T.M. Palmer, et al.. Related Traits and
Birth Weight. JAMA
315,
1129-1140 (2016) doi: 10.1001
/jama.2016.197
