Можливості верифікації позагоспітальної пневмонії в дітей за змінами багатопараметричної поляризаційно-фазової мікроскопії полікристалічних плівок легеневого експірату

Abstract

The problem of early diagnosis and selection of target treatment of pneumonia in children during the years of the COVID-19 pandemic became acute, in particular, with regard to predicting the risk of severe disease, which prompted the search for new non-invasive diagnostic methods for verifying inflammation of the lung parenchyma. Purpose - to increase the effectiveness of the diagnosis of community-acquired pneumonia in children based on the analysis of the diagnostic value of the method of multiparameter polarization-phase microscopy of polycrystalline membranes of pulmonary expiratory condensate in the aspect of differential diagnosis in relation to patients with infectious inflammatory diseases of the upper respiratory tract. Materials and methods. In the Chernivtsi Regional Pediatric Hospital, 98 children with infectious inflammatory respiratory diseases were examined, in particular, 64 patients with pneumonia and 34 children suffering from infectious and inflammatory diseases of the upper respiratory tract. Biological material was collected from patients on the first day of hospitalization. The investigation of the laser-polarimetric images structure of pulmonary expiratory condensate was carried out in the traditional arrangement of the Stokes polarimeter. A universal analytical statistical approach was used for each two-dimensional distribution of the polarization azimuth values of the polycrystalline membranes of pulmonary expiratory condensate, namely, the determination of a set of statistical moments of the 1st to 4th orders (mean, variance, skewness and kurtosis). The obtained results were analyzed using methods of clinical epidemiology. Results. Polarization azimuth indexes and histograms of their values were determined for images of pulmonary expiratory samples of both groups of children. The comparative analysis of the obtained data confirmed that both samples are characterized by optical heterogeneity as an increase in the sensitivity of polarization mapping of lung expiratory samples. An increase in the optical anisotropy of polycrystalline membranes of lung expiratory condensate from patients with pneumonia was also revealed. The obtained indexes of all statistical moments for the purpose of pneumonia verifying had high sensitivity exceeding 98% and sufficient specificity. Conclusions. Sufficient diagnostic value of the method of multi-parameter polarization-phase microscopy of pulmonary expiratory air, which can be used in the verification of inflammation of the pulmonary parenchyma in children relative to patients with infectious inflammatory diseases of the upper respiratory tract, has been established. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.