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BRONCHOOBSTRUCTIVE SYNDROME IN CHILDREN
Khudoyberdieva Shakhnoza Iskandarovna
This man is ham Zarmed University. Assistant of the Department of Clinical Sciences
Abstract
: Bronchoobstructive syndrome (BOS) in children is a clinical manifestation
characterized by partial or complete obstruction of the lower airways, leading to symptoms
such as wheezing, coughing, and difficulty breathing. It is commonly observed in various
respiratory conditions including asthma, acute bronchitis, and bronchiolitis, particularly in
early childhood. The syndrome is frequently triggered by viral infections, allergens,
environmental pollutants, or structural abnormalities of the airways. Early diagnosis and
effective management are crucial to prevent complications and improve quality of life. This
paper reviews the etiology, pathophysiology, clinical presentation, diagnostic approaches,
and current strategies in the treatment and prevention of BOS in pediatric patients. Emphasis
is placed on the importance of individualized care, environmental control, and parental
education in the management of this increasingly prevalent condition.
Keywords
: Bronchoobstructive syndrome, pediatric respiratory disorders, airway
obstruction, wheezing in children, pediatric asthma, bronchiolitis, obstructive bronchitis,
respiratory infections, childhood dyspnea, pediatric pulmonary care
Bronchial obstruction, which develops against the background of infectious diseases of the
lower respiratory tract in children, is observed, according to various authors, in 5-40%. In
children with a family history of allergies, bronchoobstructive syndrome (Bos) usually
develops in 30-40% of cases, the same trend is observed in children suffering from
respiratory infections more than 6 times a year. Bronchoobstructive syndrome (Bos) is an
urgent problem in pediatrics and occupies the first place in the structure of respiratory
diseases in children. In recent years, doctors have increasingly encountered conditions such
as bronchial obstruction during childbirth. Various factors influence the occurrence and
development of bronchoobstructive syndrome (BOS) in young children. Viral infection is of
great importance in the development of BOS. In addition, the period of early childhood is
characterized by the imperfection of many immunological mechanisms: the formation of
interferon in the upper respiratory tract, the level of immunoglobulin A in the blood serum
by the end of the first year of life is 28% of the adult level, since secretory immunoglobulin
A reaches its maximum values only at the age of 10-11 years. In addition to perinatal
pathology, allergic history, bronchial hyperreactivity, rickets, dystrophies, thymus
hyperplasia, early artificial feeding, respiratory organs observed in children 6-12 months
Bronchial diseases also play an important role in the development of bronchial obstruction.
According to the literature, there is a shortage of data for a comprehensive study of the
pathogenesis of diseases accompanied by bos, as well as for the development of new and
effective approaches to its therapy. In-depth research is needed to help develop more
effective treatment strategies for children with these diseases. In this regard, it is important
to substantiate the diagnostic criteria for cytokine status and vitamin D levels in children
with BOS.
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Based on the above, the constant work on improving medical technologies and approaches
to the prevention, diagnosis and treatment of bronchial obstruction determines the urgent
problems of pediatrics. The early diagnosis of bos, as well as the ongoing discussions about
the most favorable and least complicating treatment methods, as well as the paucity of
proven data on solving this problem in the literature, determined the goals and objectives of
the study.
The aim of the study was to assess the functional state of the respiratory system in children
with bronchoobstructive syndrome.
Materials and methods.
The study was conducted in the Department of Pulmonology of
the Andijan regional Children's Multidisciplinary Medical Center and in the Department of
Pulmonology of the Republican Specialized Pediatric Scientific and Practical Medical
Center. The study involved 90 sick children aged 7 to 15 years. 20 practically healthy
children of the same age were taken as a control group.
The study of the function of external respiration (TNOF) was carried out using the SEMA
2000 program on the Schiller srovit CP-1 spipometer (mockva). Statistical processing of the
obtained results was carried out using the Statistica 6.0 software package.
Results and its discussion.
Assessment of the functional state of the respiratory system,
which is one of the main diagnostic criteria, is important for forecasting, treating and
determining the necessary measures in the field of rehabilitation of bronchoobstructive
syndrome in children.
A peak flowmetric study showed that in children with acute obstructive bronchitis (OB) in
80.0% of cases, Ncheut was registered in more than 80% of cases, while in children with
recurrent bronchitis (BO or CB), at the same time, regulatory indicators were registered in
37.6% of children. The majority of ncheut values in the range from 80% to 60% of the norm
were recorded in 44.1% of children with boli QB and in 11.4% of children with OOB
(p<0.05).
Below the norm of 60% ncheutii in most cases (18.3%) BO li was registered in children with
QB, and in 8.6% of 6 cases in children with OOB. We would like to note that in children
with OB there is a tendency to clinical exacerbation of OB in 18.3% of cases, that is, this
group is at risk of transformation of the QB disease (Table 1).
Table 1.
Analysis results of picfloumetry data in children examined, (%)
< / Score >
O‘OB (n=40)
BO li QB (n=50)
R
abs
%
abs
%
NChEYuT, must level
80
32
80,0 %
19
37,6 % <0,001
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%
5
11,4 %
22
44,1 % <0 , 05
NChEYuT, from the
threshold
3
8,6 %
9
18,3 % <0 , 05
Usually, the spipogram is divided into types of obstructive and restrictive types, but this
indicator is relative, since in many diseases, obstructive and restrictive types of disorders can
coexist.with chronic obstructive pulmonary diseases occurring in a calf, a pathological
process may develop in the lung parenchyma, which is reflected in spirographic indications.
This development can lead to the appearance of restriction symptoms against the
background of existing obstructive symptoms.
Spirometry was used to identify syndromes of various obstructive, restrictive, or mixed
ventilation disorders in children. Interestingly, 25.8% of children with OB.while other
indicators of lung vital volume and airway permeability, measured using spirometry, were
within the normal range. It is important to note that the standard values are set only for
children with OOB, while such standards are not set for children with boli QB (Table 2).
Restrictive ventilation disorders occur due to processes that limit the stretching of the lungs
and the volume they fill with air. In the pediatric population, restrictive disorders are most
often observed (12.2%) in children with BV. Obstructive pulmonary ventilation disorders
associated with narrow airways and increased resistance to airflow are also characteristic of
respiratory diseases.
Table 2.
Spirometric parameters of patients in the study groups, (%)
Specification
O‘OB (n=22)
BOli QB (n=47)
R
abs
%
abs
%
Norm
6
25,8
6
13,4
<0,001
Obstructive type
14
59,6
26
54,4
<0 , 05
Restrictive type
-
-
6
12,2
<0 , 05
Mixed species
2
8,2
9
20
<0 , 05
In all the examined children, the obstructive type of ventilation disorder prevailed in the
groups: OOB – 14 (59.6%), bo li QB – 26 (54.4%), and a lower mixed type of ventilation
disorder was noted in all groups.: epo – 2 (8.2%), bo li QB – 9 (20%).).
An extended analysis of the function of external respiration (TNF) in the studied groups is
presented in Table 3.
Table 3. Comparative analysis of TNF in examined children, (m±m)
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Parameters
Control
group
(n=20)
O‘OB
(n=22)
BO li QB
(n=90)
P
TNChH1
88,6±1,7
71,3±1,8
65,4±0,65
<0 , 01
O‘HH
87,5±3,1
73,5±2,1
67,3±0,9
<0 , 01
TNChH1/O‘HH
(Tiffno indeksi)
80,3±2,1
62,7±1,1
53,3±1,1
<0 , 01
SHT 25
68,5±1,6
61,6±1,4
60,3±0,7
<0 , 05
SHT 50
68,5±1,6
58,8±1,2
49,4±0,6
<0,001
SHT 75
68,5±1,6
52,7±1,3
56,1±0,8
<0 , 05
The results of the TNF study in the examined patients revealed violations expressed to
varying degrees.
As can be seen from the data obtained, the tnchh1 level in patients with QB is reliably 1.1
compared to the group of children with OOB? (p<0.01).
A study of OHH levels showed that it was reliably reduced by 1.1 times in children with BO
Li QB compared with the group of children with OOB (p<0.01). There was a significant
decrease in the Tiffen index by 1.3 times compared with the group of children with BO Li
QB (P<0.01).
Compared with the group of children with OOB, children with BO li QB had a reliable
decrease in the level of ST50 by 1.1 times (p<0.05).
Conclusion. The study showed that a special type of impaired lung ventilation detected by
spirometry in children with OOB and Bo Li QB is obstructive. Based on the conducted
studies, a decrease in ugg and typhn index was found in most children, which is a symptom
of impaired bronchial permeability. This disease is usually caused by inflammatory changes
in the bronchi and lungs.
LIST OF REFERENCES:
[1]
Abrosimov, V. N. Bronchial asthma and functional respiratory disorders: syndrome
«Bronchial asthma-plus» / V. N. Abrosimov // Pulmonology. - 2018. - V. 28, No. i6. - P.
722-729.
[2]
Avdeev S. N., Nenasheva N. M., Zhudenko K. V. [et al.] Prevalence, morbidity,
phenotypes and other characteristics of severe bronchial asthma in the Russian Federation //
Pulmonology. - 2018. - Vol. 28, No. 3. - P. 341-358.
[3]
Azizova N. D. Modern approach to the treatment of bronchial asthma in children (a
modern view of the problem) // Journal of Theoretical and Clinical Medicine. - 2023. - No. 5
(68). – P. 21-24.
[4]
Aleksandrov O.K., Chernyak I.Yu., Acute respiratory diseases in children suffering
from allergic diseases // Current issues of immunology and immunology. – 2016 . – No. 3. –
P. 73-74.
Vo
lu
m
e
5,
M
ay
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
[5]
Aleshkin V., Afanasyev S., Feklisova L. Immunoglobulins and cytokines –
promising bases for drugs // Physician. – 2016. – Vol. 8. – P. 33-35.
[6]
Alimova Kh. P., Dzhubatova R. S., Nuralieva G. S., Rakhimov A. Kh., Alibekova M.
B., Ismagilova G. Kh. Differentiated approach to the treatment of acute airway obstruction
in children of the first year of life // Bulletin of Emergency Medicine. 2018. No. 4.-P. 61-64.
[7]
Arova A. A. et al. Diagnostics, etiotropic and pathogenetic treatment of acute
respiratory viral infections in children. // Medicinal Bulletin. - 2020. - V. 12 No. 4 (72). - P.
48-56.
[8]
Artamonov R. G. // Pediatrics. - 2000. - No. 5. - P. 5-6.2. Akhmetzhanova Z. I.,
Ruzybakiyev R. M. // Bulletin of the Association of Pulmonologists of Central Asia. - 2020.
- №1-4 . P. 72-76
[9]
Arutyunyan K. A., Babtseva A. F. Broncho-obstructive syndrome in young children:
a tutorial. - Blagoveshchensk: Bukvitsa. 2018.
[10]
Arkhipov V. V. et al. Comparative effectiveness of inhaled GCS // Effective
pharmacotherapy. - 2018. - №21. - P. 32-39.
