Modeling of factors associated with the pathogenesis of various forms of hypertrophy of the tonsils of the lymphoid pharyngeal ring in children of early and pre-school age

Abstract

The incidence of children with hypertrophy of the tonsils of the lymphoid pharyngeal ring remains high. Effective treatment of this pathology is determined by controllable factors associated with the pathogenesis of various forms of hypertrophy of the tonsils of the lymphoid pharyngeal ring. Multiple regression was carried out for isolated adenoid vegetation, local adenoid hypertrophy and systemic lymphoid hypertrophy in terms of 127 clinical, immunological, microbiological and genetic indicators. Individual predictors were identified for each form, reflecting the links of their pathogenesis. Logistic regression, reflecting the nonlinear relationship of the predictors with a binary variable, was reliable only in the group of systemic lymphoid hypertrophy for three predictors: the level of colonization of pharyngeal children biotope Str. pyogenes, the level of IL­1b in nasopharyngeal washings and the level of sensitization to conditionally­pathogenic microflora of pharyngeal biotope. Cluster analysis proved the isolation of this form of hypertrophy of the tonsils of the lymphoid pharyngeal ring from isolated adenoid vegetations and the local lymphoid hypertrophy. The predictors resulting from the logistic regression are controllable factors, medication treatment thereof in the early childhood will on the one hand, limit the development of hypertrophy of the tonsils of the lymphoid pharyngeal ring, and, on the other hand, prevent generation of rheumatic pathology in future.