rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric Journal3033-90063033-9014ФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2026-1-1-32-37rosped-2029Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSТоракоскопическое лечение эмпиемы плевры у детей: значимость биомаркеров в прогнозировании исходовThoracoscopic treatment of pleural empyema in children: the importance of biomarkers in predicting outcomeshttps://orcid.org/0000-0003-0847-3585ФайзиевО. Я.FayzievOtabek Ya.

Файзиев Отабек Якупджанович, доцент каф. детской хирургии, урологии, детской урологии, анестезиологии и реаниматологии, детской анестезиологии и реаниматологии

e-mail: fayziev.otabek@mail.ru

Otabek Ya. Faiziev, PhD, associate prof., Department of pediatric surgery, urology, pediatric urology, anesthesiology and resuscitation, pediatric anesthesiology and resuscitation

e-mail: fayziev.otabek@mail.ru

fayziev.otabek@mail.ruhttps://orcid.org/0000-0002-6387-574XЮсуповА. С.YusupovAnvar S.

Юсупов Анвар Сабирович, доктор мед. наук, проф. каф. детской хирургии, урологии, детской урологии, анестезиологии и реаниматологии, детской анестезиологии и реаниматологии

e-mail: anvar_mdk@mail.ru

anvar_mdk@mail.ruАкрамоваХ. А.AkramovaHursanoy A.

Акрамова Хурсаной Абдумаликовна, доктор мед. наук, доцент каф. госпитальной педиатрии и народной медицины

e-mail: xursanoyakramova@gmail.com

xursanoyakramova@gmail.comФайзиевЯ. Н.FayzievYakubdjan N.

Файзиев Якупджан Нишанович, канд. мед. наук, доцент каф. топографической анатомии и общей хирургии

e-mail: fayziyevyoqub@gmail.com

fayziyevyoqub@gmail.comАбзаловаМ. Я.AbzalovaMunisa Ya.

Абзалова ­Муниса Якуп­джановна, канд. мед. наук, доцент каф. медицинской радио­логии

e-mail: munisa7911@mail.ru

munisa7911@mail.ruТашкентский государственный медицинский университетУзбекистанTashkent State Medical UniversityUzbekistan202627032026113237Copyright © Файзиев О.Я., Юсупов А.С., Акрамова Х.А., Файзиев Я.Н., Абзалова М.Я., 20262026Файзиев О.Я., Юсупов А.С., Акрамова Х.А., Файзиев Я.Н., Абзалова М.Я.Fayziev O.Y., Yusupov A.S., Akramova H.A., Fayziev Y.N., Abzalova M.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.rosped.ru/jour/article/view/2029Введение

Введение. Эмпиема плевры (ЭП) у детей является сложной формой патологии. Несмотря на клинические успехи, остаются актуальными задачи индивидуальной оценки тяжести течения и прогнозирования исходов у детей с ЭП. В этой связи особое значение приобретают биомаркеры, отражающие интенсивность системного воспаления и динамику реконвалесценции у детей. Количественный анализ изменений содержания этих биологически активных соединений позволяет выявлять больных с высоким риском осложнений, прогнозировать динамику восстановления и оптимизировать тактику лечения. Цель: определить клиническую эффективность торакоскопического лечения ЭП у детей и значимость биомаркеров в прогнозировании клинических исходов.Материалы и методы. Обследовано 126 детей в возрасте от 1 до 17 лет с диагнозом острой ЭП, которые проходили стационарное лечение. Больные были распределены на две группы: основную составили 65 (51,6%) детей, которым на раннем этапе выполнялось видеоторакоскопическое вмешательство, в группу сравнения был включён 61 (48,4%) больной, получавший лечение ЭП без торакоскопии. У всех больных определяли концентрации биомаркеров в крови: до операции, через 24 ч после вмешательства и на 3-и сутки после операции. Количественный анализ катехоламинов (адреналин, норадреналин) выполняли методом высокоэффективной жидкостной хроматографии. Содержание кортизола, цитокинов, лактата, С-реактивного белка и прокальцитонина определяли иммунохимическими методами. Все полученные данные обработаны статистически.Результаты. У детей с ЭП содержание кортизола, адреналина и норадреналина в крови было существенно увеличено по сравнению с уровнями у больных группы сравнения. Уровень прокальцитонина у больных основной группы был увеличен более чем в 3,5 раза, что указывает на течение тяжёлой бактериальной инфекции. Концентрации цитокинов (интерлейкинов-6, -10 и фактора некроза опухоли-α) в крови детей с ЭП также были значительно увеличены, что отражает течение активного воспалительного процесса. У больных основной группы после выполнения ранней видеоторакоскопии выявлено меньшее повышение уровней биомаркеров воспаления в крови, что свидетельствует об эффективном восстановлении после операции. Мониторинг изменений этих биомаркеров при комплексной терапии ЭП у детей позволил оптимизировать лечение и улучшить клинические исходы ЭП.Заключение. Определена необходимость раннего применения видеоторакоскопического вмешательства и использования биомаркеров как значимых критериев оптимизации лечения детей с ЭП.Участие авторов: Файзиев О.Я. — концепция и дизайн исследования; Юсупов А.С., Акрамова Х.А., Файзиев Я.Н. — сбор и обработка материала; Абзалова М.Я. — статистическая обработка материала; Файзиев О.Я. — написание текста; Юсупов А.С. — редактирование. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.Финансирование. Исследование не имело финансовой поддержки.Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 16

Поступила 16.01.2026Принята к печати 10.02.2026Опубликована 27.02.2026

Introduction

Introduction. Pleural empyema in children is a complex form of pathology. Despite the clinical successes, the tasks of individually assessing the severity of the course and predicting outcomes in children with pleural empyema remain relevant. In this regard, biomarkers reflecting the intensity of systemic inflammation and the course of convalescence in children are of particular importance. Quantitative analysis of changes in the content of these biologically active compounds makes it possible to identify patients with a high risk of complications, predict recovery course and optimize treatment tactics. Aim: to determine both the clinical efficacy of thoracoscopic treatment of pleural empyema in children and the importance of biomarkers in predicting clinical outcomes.Materials and methods. There were examined 126 children aged 1 to 17 years with a diagnosis of acute pleural empyema who underwent inpatient treatment. The patients were divided into two groups: the main group consisted of 65 children (51.6%) who underwent video thoracoscopic intervention at an early stage, the comparison group included 61 patients (48.4%) who received treatment for pleural empyema without early thoracoscopy. The concentrations of biomarkers in the blood were determined in all patients: before surgery, 24 hours after the intervention, and on the 3rd day after surgery. Quantitative analysis of catecholamines (epinephrine, norepinephrine) was performed by high performance liquid chromatography (HPLC). The levels of cortisol, cytokines, lactate, C-reactive protein, and procalcitonin were determined by immunochemical methods. All the received data has been processed statistically.Results. In children with pleural empyema, the blood levels of cortisol, adrenaline, and norepinephrine were significantly increased compared with the levels in the comparison group. The level of procalcitonin in the patients of the main group was increased by more than 3.5 times, which indicates the course of a severe bacterial infection. The blood concentrations of cytokines: interleukins-6, -10 and tumor necrosis factor in children with pleural empyema were also significantly increased, reflecting the course of the active inflammatory process. In patients of the main group, after performing an early video thoracoscopy, the detected lower increase in blood levels of inflammatory biomarkers indicates to effective recovery. Monitoring of changes in these biomarkers made it possible to optimize treatment and improve the prognosis of the disease.Conclusion. The necessity of early thoracoscopic intervention and the use of biomarkers as significant criteria for optimizing the treatment of children with pleural empyema has been determined.Contributions: Faiziev O.Ya. — concept and study design; Yusupov A.S., Akramova Kh.A., Faiziev Ya.N. — data collection and processing; Abzalova M.Y. — statistical analysis; Faiziev O.Ya. — writing the text; Yusupov A.S. — editing the text. All coauthors — approval of the final version of the article, responsibility for the integrity of all parts of the article.Acknowledgments. The study had no sponsorship.Conflict of interest. The authors declare no conflict of interest.

Received

Received: January 16, 2026Accepted: February 10, 2026Published: February 27, 2026

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