tibljТуберкулез и болезни легкихTuberculosis and Lung Diseases2075-12302542-1506Медицинские знания и технологии10.21292/2075-1230-2022-100-7-59-66tiblj-1662Research ArticleОБЗОРREVIEWСовременные представления о бронхоэктазах у детейModern View on Bronchiectasis in Childrenhttps://orcid.org/0000-0001-6564-9829ФроловП. А.FrolovP. A.

Фролов Павел Александрович, ассистент кафедры педиатрии

117198, Москва, ул. Миклухо-Маклая, д. 6Тел.: +7 (495) 959-88-00, доб. 1508

Pavel A. Frolov, Assistant of Pediatrics Department

6, Miklukho-Maklaya St., Moscow, 117198Phone: +7 (495) 959-88-00, ext. 1508

9715586@gmail.comhttps://orcid.org/0000-0003-4937-716XЖестковаМ. А.ZhestkovaM. A.

Жесткова Мария Александровна, кандидат медицинских наук, доцент кафедры педиатрии

117198, Москва, ул. Миклухо-Маклая, д. 6Тел.: +7 (495) 959-88-00, доб. 1508

Maria A. Zhestkova, Candidate of Medical Sciences, Associate Professor of Pediatrics Department

6, Miklukho-Maklaya St., Moscow, 117198Phone: +7 (495) 959-88-00, ext. 1508

dr.zhestkova@gmail.comhttps://orcid.org/0000-0002-4961-384XОвсянниковД. Ю.OvsyannikovD. Yu.

Овсянников Дмитрий Юрьевич, доктор медицинских наук, заведующий кафедрой педиатрии

117198, Москва, ул. Миклухо-Маклая, д. 6Тел.: +7 (495) 959-88-00, доб. 1508

Dmitry Yu. Ovsyannikov, Doctor of Medical Sciences, Head of Pediatrics Department

6, Miklukho-Maklaya St., Moscow, 117198Phone: +7 (495) 959-88-00, ext. 1508

mdovsyannikov@yahoo.comФГАОУ ВО «Российский университет дружбы народов» Министерства науки и высшего образования РФРоссияRUDN University, Ministry of Science and Higher Education of RussiaRussian Federation20221208202210075966Copyright © Фролов П.А., Жесткова М.А., Овсянников Д.Ю., 20222022Фролов П.А., Жесткова М.А., Овсянников Д.Ю.Frolov P.A., Zhestkova M.A., Ovsyannikov D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.tibl-journal.com/jour/article/view/1662

В обзоре на основании 31 источника литературных данных представлены актуальные сведения об эпидемиологии, этиологии, патогенезе и патоморфологии, клинической, компьютерно-томографической семиотике, диагностике и дифференциальной диагностике бронхоэктазов у детей. Рекомендации по лечению и ведению детей и подростков с бронхоэктазами, не связанными с муковисцидозом, профилактике обострений бронхоэктазов приведены с позиций доказательной медицины с учетом руководства Европейского респираторного общества 2021 г.

Based on 31 publications the review provides relevant information on epidemiology, etiology, pathogenesis and pathomorphology, clinical, computed tomographic features, diagnostics, and differential diagnosis of bronchiectasis in children. Recommendations for treatment and management of children and adolescents with non-cystic fibrosis bronchiectasis, and prevention of bronchiectasis exacerbations are given from the standpoint of evidence-based medicine taking into account the guidelines of the European Respiratory Society 2021.

бронхоэктазыдетикомпьютерная томографиядиагностикалечениеbronchiectasischildrencomputed tomographydiagnosticstreatmentReferencesТаточенко В. К. Болезни органов дыхания у детей. Практическое руководство. М.: Боргес, 2019. ‒ 300 с.Tatochenko V.K. Tuberkulez organov dykhaniya u detey. Prakticheskoye Rukovodstvo. [Respiratory disease in children. Practical guidelines]. Moscow, Borges Publ., 2019, 300 p.Balci A. E., Balci T. A., Ozyurtan M. O. Current surgical therapy for bronchiectasis: surgical results and predictive factors in 86 patients // Ann. Thorac. Surg. 2014. ‒ Vol. 97, № 1. ‒ Р. 211-217. doi: 10.1016/j.athoracsur.2013.09.013.Balci A. E., Balci T. A., Ozyurtan M. O. Current surgical therapy for bronchiectasis: surgical results and predictive factors in 86 patients // Ann. Thorac. Surg. 2014. ‒ Vol. 97, № 1. ‒ Р. 211-217. doi: 10.1016/j.athoracsur.2013.09.013.Chalmers J. D., Chang A. B., Chotirmall S. H., Dhar R., McShane P. J. Bronchiectasis // Nat. Rev. Dis. Primers. ‒ 2018. ‒ Vol. 4, № 1. ‒ Р. 45. doi: 10.1038/s41572-018-0042-3.Chalmers J. D., Chang A. B., Chotirmall S. H., Dhar R., McShane P. J. Bronchiectasis // Nat. Rev. Dis. Primers. ‒ 2018. ‒ Vol. 4, № 1. ‒ Р. 45. doi: 10.1038/s41572-018-0042-3.Chang A. B., Bell S. C., Byrnes C. A., Grimwood K., Holmes P. W., King P. T., Kolbe J., Landau L. I., Maguire G. P., McDonald M. I., Reid D. W., Thien F. C., Torzillo P. J. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand // Med. J. Aust. ‒ 2015. ‒ Vol. 193, № 6. ‒ Р. 356-365. doi: 10.5694/j.1326-5377.2010.tb03949.x.Chang A. B., Bell S. C., Byrnes C. A., Grimwood K., Holmes P. W., King P. T., Kolbe J., Landau L. I., Maguire G. P., McDonald M. I., Reid D. W., Thien F. C., Torzillo P. J. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand // Med. J. Aust. ‒ 2015. ‒ Vol. 193, № 6. ‒ Р. 356-365. doi: 10.5694/j.1326-5377.2010.tb03949.x.Chang A. B., Bush A., Grimwood K. Bronchiectasis in children: diagnosis and treatment // Lancet. ‒ 2018. ‒ Vol. 392. ‒ Р. 866-879. doi: 10.1016/S0140-6736(18)31554-X.Chang A. B., Bush A., Grimwood K. Bronchiectasis in children: diagnosis and treatment // Lancet. ‒ 2018. ‒ Vol. 392. ‒ Р. 866-879. doi: 10.1016/S0140-6736(18)31554-X.Chang A. B., Fortescue R., Grimwood K., Alexopoulou E., Bell L., Boyd J., Bush A., Chalmers J. D., Hill A. T., Karadag B., Midulla F., McCallum G. B., Powell Z., Snijders D., Song W. J., Tonia T., Wilson C., Zacharasiewicz A., Kantar A. European Respiratory Society guidelines for the management of children and adolescents with bronchiectasis // Eur. Respir. J. ‒ 2021. ‒ Vol. 58, № 2. ‒ 2002990. doi: 10.1183/13993003.02990-2020.Chang A. B., Fortescue R., Grimwood K., Alexopoulou E., Bell L., Boyd J., Bush A., Chalmers J. D., Hill A. T., Karadag B., Midulla F., McCallum G. B., Powell Z., Snijders D., Song W. J., Tonia T., Wilson C., Zacharasiewicz A., Kantar A. European Respiratory Society guidelines for the management of children and adolescents with bronchiectasis // Eur. Respir. J. ‒ 2021. ‒ Vol. 58, № 2. ‒ 2002990. doi: 10.1183/13993003.02990-2020.Chang A. B., Oppenheimer J. J., Weinberger M. M., Rubin B. K., Grant C. C., Weir K., Irwin R. S. CHEST Expert Cough Panel. Management of children with chronic wet cough and protracted bacterial bronchitis: CHEST Guideline and Expert Panel Report // Chest. ‒ 2017. ‒ Vol. 151. ‒ Р. 884-890. doi: 10.1016/j.chest.2017.01.025.Chang A. B., Oppenheimer J. J., Weinberger M. M., Rubin B. K., Grant C. C., Weir K., Irwin R. S. CHEST Expert Cough Panel. Management of children with chronic wet cough and protracted bacterial bronchitis: CHEST Guideline and Expert Panel Report // Chest. ‒ 2017. ‒ Vol. 151. ‒ Р. 884-890. doi: 10.1016/j.chest.2017.01.025.Coutinho D., Fernandes P., Guerra M., Miranda J., Vouga L. Surgical treatment of bronchiectasis: A review of 20 years of experience // Rev. Port. Pneumol. 2016. ‒ Vol. 22, № 2. ‒ Р. 82-85. doi: 10.1016/j.rppnen.2015.09.007.Coutinho D., Fernandes P., Guerra M., Miranda J., Vouga L. Surgical treatment of bronchiectasis: A review of 20 years of experience // Rev. Port. Pneumol. 2016. ‒ Vol. 22, № 2. ‒ Р. 82-85. doi: 10.1016/j.rppnen.2015.09.007.Diaz A. A., Young T. P., Maselli D. J., Martinez C. H., Gill R., Nardelli P., Wang W., Kinney G. L., Hokanson J. E., Washko G. R., San Jose Estepar R. Quantitative CT measures of bronchiectasis in smokers // Chest. ‒ 2017. ‒ Vol. 151, № 6. Р. 1255-1262. doi: 10.1016/j.chest.2016.11.024.Diaz A. A., Young T. P., Maselli D. J., Martinez C. H., Gill R., Nardelli P., Wang W., Kinney G. L., Hokanson J. E., Washko G. R., San Jose Estepar R. Quantitative CT measures of bronchiectasis in smokers // Chest. ‒ 2017. ‒ Vol. 151, № 6. Р. 1255-1262. doi: 10.1016/j.chest.2016.11.024.Fakhoury K., Kanu A. (2021). Causes of bronchiectasis in children. UpToDate. Дата обращения 20.11.2021. https://www.uptodate.com/contents/causes-ofbronchiectasis-in-children.Fakhoury K., Kanu A. (2021). Causes of bronchiectasis in children. UpToDate. https://www.uptodate.com/contents/causes-ofbronchiectasis-in-children.Goyal V., Chang A. B. (2021). Clinical manifestations and evaluation of bronchiectasis in children. UpToDate. Дата обращения 20.11.2021. https://www.uptodate.com/contents/clinical-manifestations-and-evaluation-of-bronchiectasis-in-children.Goyal V., Chang A. B. (2021). Clinical manifestations and evaluation of bronchiectasis in children. UpToDate. Дата обращения 20.11.2021. https://www.uptodate.com/contents/clinical-manifestations-and-evaluation-of-bronchiectasis-in-children.Goyal V., Grimwood K., Marchant J., Masters I. B., Chang A. B. Pediatric bronchiectasis: no longer an orphan disease // Pediatr. Pulmonol. ‒ 2016. Vol. 51. ‒ Р. 450-569. doi: 10.1002/ppul.23380.Goyal V., Grimwood K., Marchant J., Masters I. B., Chang A. B. Pediatric bronchiectasis: no longer an orphan disease // Pediatr. Pulmonol. ‒ 2016. Vol. 51. ‒ Р. 450-569. doi: 10.1002/ppul.23380.Hall-Stoodley L., Stoodley P., Kathju S., Hoiby N., Moser C., William C. J., Moter A., Bjarnsholt T. Towards diagnostic guidelines for biofilm-associated infections // FEMS Immunol. Med. Microbiol. ‒ 2012. ‒ Vol. 65. ‒ Р. 127-145. doi: 10.1111/j.1574-695X.2012.00968.x.Hall-Stoodley L., Stoodley P., Kathju S., Hoiby N., Moser C., William C. J., Moter A., Bjarnsholt T. Towards diagnostic guidelines for biofilm-associated infections // FEMS Immunol. Med. Microbiol. ‒ 2012. ‒ Vol. 65. ‒ Р. 127-145. doi: 10.1111/j.1574-695X.2012.00968.x.Javidan-Nejad C., Bhalla S. Bronchiectasis // Thorac. Surg. Clin. ‒ 2010. ‒ Vol. 20, № 1. ‒ Р. 85-102. doi: 10.1016/j.thorsurg.2009.12.007.Javidan-Nejad C., Bhalla S. Bronchiectasis // Thorac. Surg. Clin. ‒ 2010. ‒ Vol. 20, № 1. ‒ Р. 85-102. doi: 10.1016/j.thorsurg.2009.12.007.Kapur N., Grimwood K., Masters I. B., Morris P. S., Chang A. B. Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis // Pediatr. Pulmonol. ‒ 2012. ‒ Vol. 47, № 3. ‒ Р. 300-307. doi: 10.1002/ppul.21550.Kapur N., Grimwood K., Masters I. B., Morris P. S., Chang A. B. Lower airway microbiology and cellularity in children with newly diagnosed non-CF bronchiectasis // Pediatr. Pulmonol. ‒ 2012. ‒ Vol. 47, № 3. ‒ Р. 300-307. doi: 10.1002/ppul.21550.Kapur N., Karadag B. Differences and similarities in non-cystic fibrosis bronchiectasis between developing and affluent countries // Paediatr. Respir. Rev. ‒ 2011. ‒ Vol. 12. ‒ Р. 91-96. doi: 10.1016/j.prrv.2010.10.010.Kapur N., Karadag B. Differences and similarities in non-cystic fibrosis bronchiectasis between developing and affluent countries // Paediatr. Respir. Rev. ‒ 2011. ‒ Vol. 12. ‒ Р. 91-96. doi: 10.1016/j.prrv.2010.10.010.Kapur N., Masters I. B., Newcombe P., Chang A. B. The burden of disease in pediatric non-cystic fibrosis bronchiectasis // Chest. ‒ 2012. ‒ Vol. 141. Р. 1018-1024. doi: 10.1378/chest.11-0679.Kapur N., Masters I. B., Newcombe P., Chang A. B. The burden of disease in pediatric non-cystic fibrosis bronchiectasis // Chest. ‒ 2012. ‒ Vol. 141. Р. 1018-1024. doi: 10.1378/chest.11-0679.Kuo W., de Bruijne M., Petersen J., Nasserinejad K., Ozturk H., Chen Y., Perez-Rovira A., Tiddens H. A. W. M. Diagnosis of bronchiectasis and airway wall thickening in children with cystic fibrosis: objective airway-artery quantification // Eur. Radiol. ‒ 2017. ‒ Vol. 27. ‒ Р. 4680-4689. doi: 10.1007/s00330-017-4819-7.Kuo W., de Bruijne M., Petersen J., Nasserinejad K., Ozturk H., Chen Y., Perez-Rovira A., Tiddens H. A. W. M. Diagnosis of bronchiectasis and airway wall thickening in children with cystic fibrosis: objective airway-artery quantification // Eur. Radiol. ‒ 2017. ‒ Vol. 27. ‒ Р. 4680-4689. doi: 10.1007/s00330-017-4819-7.Lee E., Hong S. J. Pharmacotherapeutic strategies for treating bronchiectasis in pediatric patients // Expert. Opin. Pharmacother. ‒ 2019. ‒ Vol. 20, № 8. Р. 1025-1036. doi: 10.1080/14656566.2019.1589453.Lee E., Hong S. J. Pharmacotherapeutic strategies for treating bronchiectasis in pediatric patients // Expert. Opin. Pharmacother. ‒ 2019. ‒ Vol. 20, № 8. Р. 1025-1036. doi: 10.1080/14656566.2019.1589453.Maglione M., Bush A., Montella S., Mollica C., Manna A., Esposito A., Santamaria F. Progression of lung disease in primary ciliary dyskinesia: is spirometry less accurate than CT? // Pediatr. Pulmonol. ‒ 2012. ‒ Vol. 47. Р. 498-504. doi: 10.1002/ppul.21569.Maglione M., Bush A., Montella S., Mollica C., Manna A., Esposito A., Santamaria F. Progression of lung disease in primary ciliary dyskinesia: is spirometry less accurate than CT? // Pediatr. Pulmonol. ‒ 2012. ‒ Vol. 47. Р. 498-504. doi: 10.1002/ppul.21569.Mallick M. S. Tracheobronchial foreign body aspiration in children: A continuing diagnostic challenge // Afr. J. Paediatr. Surg. ‒ 2014. ‒ Vol. 11, № 3. ‒ Р. 225-228. doi: 10.4103/0189-6725.137330.Mallick M. S. Tracheobronchial foreign body aspiration in children: A continuing diagnostic challenge // Afr. J. Paediatr. Surg. ‒ 2014. ‒ Vol. 11, № 3. ‒ Р. 225-228. doi: 10.4103/0189-6725.137330.Marsh R. L., Thornton R. B., Smith-Vaughan H. C., Richmond P., Pizzutto S. J., Chang A. B. Detection of biofilm in bronchoalveolar lavage from children with non-cystic fibrosis bronchiectasis // Pediatr. Pulmonol. ‒ 2015. ‒ Vol. 50, № 3. ‒ Р. 284-292. doi: 10.1002/ppul.23031.Marsh R. L., Thornton R. B., Smith-Vaughan H. C., Richmond P., Pizzutto S. J., Chang A. B. Detection of biofilm in bronchoalveolar lavage from children with non-cystic fibrosis bronchiectasis // Pediatr. Pulmonol. ‒ 2015. ‒ Vol. 50, № 3. ‒ Р. 284-292. doi: 10.1002/ppul.23031.McCallum G. B., Binks M. J. The epidemiology of chronic suppurative lung disease and bronchiectasis in children and adolescents // Front. Pediatr. ‒ 2017. Vol. 5. ‒ Р. 27. doi: 10.3389/fped.2017.00027.McCallum G. B., Binks M. J. The epidemiology of chronic suppurative lung disease and bronchiectasis in children and adolescents // Front. Pediatr. ‒ 2017. Vol. 5. ‒ Р. 27. doi: 10.3389/fped.2017.00027.Melani A. S., Lanzarone N., Rottoli P. The pharmacological treatment of bronchiectasis // Expert. Rev. Clin. Pharmacol. ‒ 2018. ‒ Vol. 11, № 3. Р. 245-258. doi: 10.1080/17512433.2018.1421064.Melani A. S., Lanzarone N., Rottoli P. The pharmacological treatment of bronchiectasis // Expert. Rev. Clin. Pharmacol. ‒ 2018. ‒ Vol. 11, № 3. Р. 245-258. doi: 10.1080/17512433.2018.1421064.O'Grady K. F., Cripps A. W., Grimwood K. Paediatric and adult bronchiectasis: Vaccination in prevention and management // Respirology. ‒ 2019. ‒ Vol. 24, № 2. ‒ Р. 107-114. doi: 10.1111/resp.13446.O'Grady K. F., Cripps A. W., Grimwood K. Paediatric and adult bronchiectasis: Vaccination in prevention and management // Respirology. ‒ 2019. ‒ Vol. 24, № 2. ‒ Р. 107-114. doi: 10.1111/resp.13446.Rothenberg S. S., Kuenzler K. A., Middlesworth W. Thoracoscopic lobectomy for severe bronchiectasis in children // J. Laparoendosc. Adv. Surg. Tech. A. 2009. ‒ Vol. 19, № 4. ‒ Р. 555-557. doi: 10.1089/lap.2009.0093.Rothenberg S. S., Kuenzler K. A., Middlesworth W. Thoracoscopic lobectomy for severe bronchiectasis in children // J. Laparoendosc. Adv. Surg. Tech. A. 2009. ‒ Vol. 19, № 4. ‒ Р. 555-557. doi: 10.1089/lap.2009.0093.Shoemark A., Dell S., Shapiro A., Lucas J. S. ERS and ATS diagnostic guidelines for primary ciliary dyskinesia: similarities and differences in approach to diagnosis // Eur. Respir. J. ‒ 2019. ‒ Vol. 54, № 3. ‒ Р. 1901066. doi: 10.1183/13993003.01066-2019.Shoemark A., Dell S., Shapiro A., Lucas J. S. ERS and ATS diagnostic guidelines for primary ciliary dyskinesia: similarities and differences in approach to diagnosis // Eur. Respir. J. ‒ 2019. ‒ Vol. 54, № 3. ‒ Р. 1901066. doi: 10.1183/13993003.01066-2019.Starner T. D., Shrout J. D., Parsek M. R., Appelbaum P. C., Kim G. Subinhibitory concentrations of azithromycin decrease nontypeable Haemophilus influenzae biofilm formation and Diminish established biofilms // Antimicrob. Agents. Chemother. ‒ 2008. ‒ Vol. 52, № 1. ‒ Р. 137-145. doi: 10.1128/AAC.00607-07.Starner T. D., Shrout J. D., Parsek M. R., Appelbaum P. C., Kim G. Subinhibitory concentrations of azithromycin decrease nontypeable Haemophilus influenzae biofilm formation and Diminish established biofilms // Antimicrob. Agents. Chemother. ‒ 2008. ‒ Vol. 52, № 1. ‒ Р. 137-145. doi: 10.1128/AAC.00607-07.Tiddens H. A. W. M., Meerburg J. J., van der Eerden M. M., Ciet P. The radiological diagnosis of bronchiectasis: what's in a name? // Eur. Respir Rev. 2020. ‒ Vol. 29 (156). ‒ Р. 190120. doi: 10.1183/16000617.0120-2019.Tiddens H. A. W. M., Meerburg J. J., van der Eerden M. M., Ciet P. The radiological diagnosis of bronchiectasis: what's in a name? // Eur. Respir Rev. 2020. ‒ Vol. 29 (156). ‒ Р. 190120. doi: 10.1183/16000617.0120-2019.Wurzel D. F., Marchant J. M., Yerkovich S. T., Upham J. W., Petsky H. L., Smith-Vaughan H., Masters B., Buntain H., Chang A. B. Protracted bacterial bronchitis in children: natural history and risk factors for bronchiectasis // Chest. ‒ 2016. ‒ Vol. 150, № 5. ‒ Р. 1101-1108. doi: 10.1016/j.chest.2016.06.030.Wurzel D. F., Marchant J. M., Yerkovich S. T., Upham J. W., Petsky H. L., Smith-Vaughan H., Masters B., Buntain H., Chang A. B. Protracted bacterial bronchitis in children: natural history and risk factors for bronchiectasis // Chest. ‒ 2016. ‒ Vol. 150, № 5. ‒ Р. 1101-1108. doi: 10.1016/j.chest.2016.06.030.Zheng L., Lam W. K., Tipoe G. L, Shum I. H., Yan C., Leung R., Sun J., Ooi G. C., Tsang K. W. Overexpression of matrix metal- loproteinase-8 and -9 in bronchiectatic airways in vivo // Eur. Respir. J. ‒ 2002. ‒ Vol. 20, № 1. ‒ Р. 170-176. doi: 10.1183/09031936.02.00282402.Zheng L., Lam W. K., Tipoe G. L, Shum I. H., Yan C., Leung R., Sun J., Ooi G. C., Tsang K. W. Overexpression of matrix metal- loproteinase-8 and -9 in bronchiectatic airways in vivo // Eur. Respir. J. ‒ 2002. ‒ Vol. 20, № 1. ‒ Р. 170-176. doi: 10.1183/09031936.02.00282402.

The authors declare that there are no conflicts of interest present.