“Mathematical model” diagnosis of asthma in young children

Abstract

Introduction: The current literature is still a controversial question of the possibility konstellation approach to the integrated use of indicators of clinical and immunological examination criteria as early diagnosis of bronchial asthma in children under three years with the presence of airflow obstruction syndrome, as well as the effectiveness of treatment and prognosis of asthma. Accordingly, the purpose of the work was the creation of a mathematical model of asthma in young children, which is necessary for the purpose of a rational treatment strategy in patients with bronchial asthma. Survey methods: to achieve this goal we carried out a comprehensive clinical and immunological study of 55 children aged 3 years, patients with asthma, which included a thorough investigation of allergic history, clinical signs of expression of broncho-obstructive syndrome, to determine the level of CD4 +, CD8 + lymphocytes, total Ig E, the metabolic activity of the blood eosinophil according to NBT-test, the intracellular content of the main cytotoxic substances eosinophils (cationic protein, peroxidase). The results: The analysis found that none of these criteria have sufficient sensitivity, specificity, to be used independently for the production or exclude the diagnosis of asthma. Multivariate analysis of clinical - laboratory data allowed to identify the major components of the factor structure of clinical - paraclinical “image” of asthma in young children. Based on a study of the factor loading main components of multi-factor matrix was established a factor structure of the image of Asthma: Asthma = 0,6 FI + (-0,3) F2 +0,3 F3, where FI - particularly the immune status of the child in the form of increasing the content of blood CD4 - lymphocytes and decreased CD8, as well as improve the immuno-regulatory index (CD4/ CD8) greater than 2.0. Factor loadings of the indicator 0,72; F2 - negative reserve oxygen-dependent metabolism of eosinophilic granulocytes of peripheral blood according to the spontaneous and stimulated NBT test, reduced the intracellular content of cationic proteins (<1.4 USD) and peroxidase (<1.7 USD). Factor loadings of these indicators were within 0,84 - 0,86; F3 - rates the severity of airflow obstruction syndrome during the first three days of treatment in the hospital. Factor loadings measure severity of broncho-obstructive syndrome in the first day of hospitalization was - 0.91 for the second - 0.94, on the third - 0.88; Conclusion: Thus, our multivariate analysis using the principal component analysis allowed establishing the factor structure of diagnosis “bronchial asthma”.