Бронхолегочная дисплазия (БЛД) впервые была описана в 1967 г. на основании корреляции морфологических и рентгенографических изменений у недоношенных детей, находившихся на искусственной вентиляции легких. С тех пор был предложен ряд рентгенологических шкал диагностики БЛД с различной информативностью и диагностической ценностью. В обзоре на основании данных литературы и результатов собственных исследований и клинических наблюдений приводятся рентгеноморфологические сопоставления при БЛД, рентгенологические шкалы диагностики заболевания, информация о дифференциальной диагностике, рентгенологических изменениях по мере увеличения возраста ребенка.Финансирование. Исследование выполнено в рамках инициативной научно-исследовательской работы Медицинского института РУДН по теме № 031216-0-000 «Изучение клинико-патогенетических аспектов приобретенных и врожденных заболеваний дыхательной системы у детей». Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. Вклад авторов. Разработка концепции и дизайна, написание статьи, сбор, анализ и интерпретация данных, окончательное утверждение рукописи -Овсянников Д.Ю.; сбор, анализ и интерпретация данных -Кршеминская И.В.; сбор, анализ и интерпретация данных -Даниэл-Абу М.И.; сбор, анализ и интерпретация данных, подготовка статьи к печати -Карпенко М.А. Благодарности. Авторы выражают благодарность сотрудникам ГБУЗ «Морозовская ДГКБ ДЗМ», ГБУЗ «ДИКБ № 6 ДЗМ», на базе которых проводилось наблюдение пациентов с бронхолегочной дисплазией.
Introduction: The relationship between objective indicators of nasal obstruction and airflow limitation in children with bronchial asthma (BA) and allergic rhinitis (AR) has not yet been studied.Objective: To study the relationship between objective parameters of nasal obstruction and airflow limitation, determined using the methods of anterior active rhinomanometry (AARM) and spirometry in children with BA and AR.Materials and Methods: Eighty eight children and adolescents with BA and AR, boys−65.9% (58/88), were examined. The median age was 11.09 [10.42; 11.76] years. To determine airflow limitation, the following spirometric parameters were evaluated: forced vital capacity of the lungs (FVC), forced expiratory volume in 1 s (FEV1), the ratio of FEV1/FVC, and maximum expiratory flow at the point 25% of the flow-volume loop (MEF25). Data were recorded both in absolute values and in relative units (% pred). Nasal respiratory function was determined by AARM based on the total nasal airflow (TNAF) in absolute (Pa/cm3/s) and relative units (RTNAF, % pred).Results: In the general cohort and in boys but not in girls, a statistically significant direct correlation was found between TNAF (Pa/cm3/s) and absolute spirometry parameters of bronchial patency—all had p < 0.01. Also, RTNAF and relative MEF25 values (% pred) in the general cohort were R = 0.22, p = 0.04, and in boys, R = 0.28, p = 0.03. In girls, there was no statistically significant correlation between nasal respiratory function and spirometric parameters, all p > 0.05. Additional analysis of literature was conducted to ascertain that the identified gender differences were not occasional.Conclusion: The significant positive correlation of absolute values of AARM and spirometric parameters in children with BA and AR was established, which apparently reflects the physical development of children. Of all the relative indicators of spirometry, only MEF25 (% pred), which indirectly reflects the patency of small bronchi, had a distinct direct correlation with RTNAF. These patterns are clearly expressed in boys with BA. In girls with this disease, however, the relationship between nasal respiratory function and spirometric indicators seems to be more complex and requires further study.
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