Introduction. In the world of bronchopulmonary diseases, one of the unresolved problems of modern pediatrics remains. In the past 10 years, pneumonia has been a leader among these diseases. Community-acquired pneumonia is an acute disease that has occurred in community-acquired conditions, accompanied by symptoms of lower respiratory tract infection and fresh focal-infiltrative changes in the lungs. The aim of the study was to develop a differentiated treatment method for the protracted course of community-acquired pneumonia in children and to assess their effect on the cytokine status. Materials and methods. We analyzed 853 case histories of children treated in Prospectively; under our supervision, there were 123 children who were divided into group II. The first group included 65 children (community-acquired pneumonia (CAP) for a prolonged period), the second control group included 58 children (community-acquired pneumonia for an acute course). In the process of a comprehensive clinical and laboratory examination of children, biochemical, microbiological and immunological research methods were used. Enzyme-linked immunosorbent assay (determination of markers of interleukin-4.6, tumor necrosis factor-alpha) was carried out in a private clinic INNOVA in Samarkand, microbiological studies. Results. When studying the history of these children, a number of adverse factors were noted. Thus, 45.5% (56) of the mothers of the observed children had toxicosis of the first and second half of pregnancy, a miscarriage threat in 42.3% (52), and anemia I-II degree in 84.6% (104). In the main group, 21.5% of children were born in asphyxia, and 2.5 times less in the comparison group (8.6%; P <0.05). When analyzing the medical history, it was noted that premature birth among patients with community-acquired pneumonia was 4.9%: 6.2% in the main group and 3.4% in the comparison group. 57.5% (88) of the mothers had acute respiratory infections during pregnancy. Most mothers of children - 69.6% had foci of chronic infection. Laboratory data: Data showed that the level of interleukin-4 in children with community-acquired pneumonia was 2.3 times higher than the control, increasing to 10.8 ± 0.9 pg / ml (P <0.01), relative to the control group. Interleukin-6 was 13.4 ± 0.3 pg / ml and was 2 times higher than in the control group (p <0.05). Tumor necrosis factor-alpha up to 63.5 ± 3.2 pg / ml compared with the (P <0.01) control group. Conclusion. In order to correct the revealed changes, differentiated treatment regimens for children with community-acquired pneumonia have been developed and recommended. In the acute period of the disease, Bronchomunal P (3.5 mg) was prescribed 1 capsule / day until the symptoms of the disease disappeared, but not less than 10 days. With a prolonged course of the disease, 1 capsule / day for 1 month. In the next 2 months, the drug is used in 1 capsule for 10 days with a 20-day interval between courses.
Volume 12 | Issue 5
Pages: 147-156
DOI: 10.5373/JARDCS/V12I5/20201698