Роль факторов риска в детском возрасте на формирование хронической обструктивной болезни легких

Abstract

An analysis of literature on COPD in children has shown that COPD arises from an accelerated decline in lung function, an inability to achieve normal lung function after childhood, or a combination of the two. Risk factors for the development of COPD are considered negative environmental influences; maternal smoking, intrauterine development disorders, prematurity, low birth weight, bronchopulmonary dysplasia, as well as frequent or severe respiratory infections in childhood (especially respiratory syncytial virus and rhinovirus) that prevent the full growth and development of the lungs; asthma in childhood; early allergic sensitization and/or a rare genetic disorder (alpha‑1 antitrypsin deficiency), childhood chronic cough, parental history of respiratory disease, and low educational attainment. Particularly vulnerable are children from socio-economically low strata of the population, in particular, from among the indigenous population of multi-ethnic countries. In low- and middle-income countries, diagnosing COPD is difficult, and the disease may go undiagnosed. Bronchial asthma in childhood can be considered as an independent risk factor for COPD in adulthood. At the same time, the asthma-COPD overlap syndrome is widespread, the risk of which is especially high among individuals with persistent and severe childhood asthma, which is highly dependent on genetics. Targeted programs are needed to reduce the risk of adverse pulmonary outcomes in disadvantaged children, as well as the integration of specialized outreach services into primary health care. The WHO COPD core package includes protocols for assessing, diagnosing and managing COPD, as well as modules on healthy lifestyles, including smoking cessation and self-help, and development of rehabilitation services.