Abstract
Bronchial asthma is a common multifactorial disease in children requiring long‐term therapy to achieve control, focuses on the need for anti‐inflammatory therapy, regardless of the severity of clinical manifestations. Material 47 children have been examined with diagnosis – bronchial asthma during exacerbations (4), the rest ‐ in the period of clinical well‐being. 26 children expressed medium‐heavy course (55.3%), severe ‐ in 21 children (44.7%). The average age of the patients was 5,0±2,4 (30 boys and 17 girls aged from 2 to 14 years), duration of the disease 4,05±3.1. All children had symptoms of the disease all year ‐ round, remission lasted no more than 4‐5 months per year. Changes of bronchial mucosa have been revealed during the fibrobronchoscopy of children with asthma in all cases. Frequency of atrophic/subatrophic symptoms has been increased and hyperplasia/hypertrophy is decreased with increasing duration of the disease. Symptoms atrophy subatrophy mucous found in 55.3% of cases. Signs of atrophy often determined on the right, sometimes on both sides or on the left. Pathological secretion in the bronchi found in 40 patients (85.1%), and in attack period in all cases and in remission ‐ in 80.8%. A microscopic and microbiological examination of broncho‐alveolar fluid has been conducted. Elevated levels of neutrophils to 12,6±0,07% to 17,5±2,2% and reduced ‐ macrophages with 24,8±1,6% to 20.7±0,8% (p<0.05) have been found with increasing severity of asthma. Morphological analysis of bronchobiopsy in patients with asthma found that the heavy course is characterized with more intense sloughing of the mucosa and thickening of the basement membrane ‐ as a biological marker of disease severity.