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Бронхиальная обструкция у детей дошкольного возраста
Бронхиальная обструкция у детей дошкольного возраста
Геппе Н.А., Колосова Н.Г. Бронхиальная обструкция у детей дошкольного возраста. Consilium Medicum. 2016; 18 (11): 25–29. DOI: 10.26442/2075-1753_2016.11.25-29
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Аннотация
Частота бронхиальной обструкции (БО) у детей первых 5 лет жизни определяет необходимость дифференциальной диагностики различных состояний и определения тактики ведения пациентов с повторными эпизодами БО. Несмотря на выделение отдельных фенотипов БО (эпизодический вирусный и мультитриггерный), показано, что различие между данными фенотипами не столь четкое, как предполагалось ранее, поскольку они значительно изменяют свою характеристику уже в течение года. Дети дошкольного возраста с эпизодическими, но тяжелыми обструкциями с госпитализацией имеют высокий риск персистирующей астмы к 5–10 годам. Необходимо оценивать риск астмы у таких детей с целью мониторирования течения заболевания и раннего назначения контролирующей терапии.
Ключевые слова: бронхиальная обструкция, бронхиальная астма, терапия, дети раннего возраста.
Ключевые слова: бронхиальная обструкция, бронхиальная астма, терапия, дети раннего возраста.
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The frequency of bronchial obstruction (BO) in children during the first 5 years of life determines the need for differential diagnosis of various conditions and determine the tactics of patients with repeated episodes of BO. Despite the isolation of specific BO phenotypes (episodic viral and multitriggerny), shows that the difference between the phenotypes are not as accurate as previously thought, as they significantly change their characteristic in the course of the year. Preschool children with occasional but severe obstruction hospitalization are at high risk of persistent asthma in 5–10 years. The risk of asthma in children must be assessed with a view of monitoring the disease and the early initiation of therapy controls.
Key words: airflow obstruction, bronchial asthma, treatment, young children.
Key words: airflow obstruction, bronchial asthma, treatment, young children.
Полный текст
Список литературы
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2. Ducharme FM, Tse SM, Chauhan B. Diagnosis, management, and prognosis of preschool wheeze. Lancet 2014; 383 (9928): 1593–604.
3. Cano-Garcinuño A, Mora-Gandarillas I; SLAM Study Group. Wheezing phenotypes in young children: an historical cohort study. Prim Care Respir J 2014; 23 (1): 60–6.
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7. Raedler D, Ballenberger N, Klucker E et al. Identification of novel immune phenotypes for allergic and nonallergic childhood asthma. J Allergy Clin Immunol 2015; 135 (1): 81–91.
8. Castro-Rodriguez JA, Holberg C J, Wright AL, Martinez F D. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000; 162: 1403–6.
9. Bacharier LB, Boner A, Carlsen KH et al; European Pediatric Asthma Group. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy 2008; 63 (1): 5–34.
10. Papadopoulos NG, Arakawa H, Carlsen KH et al. International consensus on (ICON) pediatric asthma. Allergy 2012; 67 (8): 976–97.
11. Global Initiative for Asthma (GINA). Pocket Guide for Asthma Management and Prevention in Children 5 Years and Younger, updated April 2015. Available from: http://www.ginasthma.org/local/uploads/files/GINA_PediatricPocket_2015.pdf.
12. Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика». Изд. 4-е. М., 2012. / Natsional'naia programma «Bronkhial'naia astma u detei. Strategiia lecheniia i profilaktika». Izd. 4-e. M., 2012. [in Russian]
13. Potter PC. Current guidelines for the management of asthma in young children. Allergy Asthma Immunol Res 2010; 2 (1): 1–13.
14. Durrani S, Guilbert TW. Early treatment in preschool children: an evidence-based approach. Curr Opin Allergy Clin Immunol 2015; 15 (2): 175–83.
15. Jackson DJ. Emerging issues in pediatric asthma: gaps in EPR-3 guidelines for infants and children. Curr Allergy Asthma Rep 2014; 14 (12): 477.
16. Paul LP et al. Eur Res J 2014; 43 (4): 1172–7. http://erj.ersjournals.com/content/43/4/1172.
17. Guilbert TW, Morgan WJ, Zeiger RS et al. Long term inhaled corticosteroids in preschool children at high risk for asthma. N Eng J Med 2006; 354 (19): 1985–97.
18. Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics 2009; 123: e519–25.
19. Camargo CA, Ramachandran S, Ryskina KL et al. Association between common asthma therapies and recurrent asthma exacerbations in children enrolled in a state Medicaid plan. Am J Health Syst Pharmacy 2007; 64: 1054–61.
20. Boluyt N, Rottier BL, de Jongste JC et al. Assessment of controversial pediatric asthma management options using GRADE. Pediatrics 2012; 130: e658–e668. http://pediatrics.aappublications.org/content/130/3/e658?ijkey=31dccd4001bc31f79db1fa765e97dde9eb9f9...
2. Ducharme FM, Tse SM, Chauhan B. Diagnosis, management, and prognosis of preschool wheeze. Lancet 2014; 383 (9928): 1593–604.
3. Cano-Garcinuño A, Mora-Gandarillas I; SLAM Study Group. Wheezing phenotypes in young children: an historical cohort study. Prim Care Respir J 2014; 23 (1): 60–6.
4. Just J, Saint-Pierre P, Amat F et al. What lessons can be learned about asthma phenotypes in children from cohort studies? Pediatr Allergy Immunol 2015; 26 (4): 300–5.
5. ERS Task Force, Brand P. Eur Respir J 2008; 32: 1096–110.
6. Just J, Saint-Pierre P, Gouvis-Echraghi R et al. Wheeze phenotypes in young children have different courses during the preschool period. Ann Allergy Asthma Immunol 2013; 111 (4): 256–61.
7. Raedler D, Ballenberger N, Klucker E et al. Identification of novel immune phenotypes for allergic and nonallergic childhood asthma. J Allergy Clin Immunol 2015; 135 (1): 81–91.
8. Castro-Rodriguez JA, Holberg C J, Wright AL, Martinez F D. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000; 162: 1403–6.
9. Bacharier LB, Boner A, Carlsen KH et al; European Pediatric Asthma Group. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy 2008; 63 (1): 5–34.
10. Papadopoulos NG, Arakawa H, Carlsen KH et al. International consensus on (ICON) pediatric asthma. Allergy 2012; 67 (8): 976–97.
11. Global Initiative for Asthma (GINA). Pocket Guide for Asthma Management and Prevention in Children 5 Years and Younger, updated April 2015. Available from: http://www.ginasthma.org/local/uploads/files/GINA_PediatricPocket_2015.pdf.
12. Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика». Изд. 4-е. М., 2012. / Natsional'naia programma «Bronkhial'naia astma u detei. Strategiia lecheniia i profilaktika». Izd. 4-e. M., 2012. [in Russian]
13. Potter PC. Current guidelines for the management of asthma in young children. Allergy Asthma Immunol Res 2010; 2 (1): 1–13.
14. Durrani S, Guilbert TW. Early treatment in preschool children: an evidence-based approach. Curr Opin Allergy Clin Immunol 2015; 15 (2): 175–83.
15. Jackson DJ. Emerging issues in pediatric asthma: gaps in EPR-3 guidelines for infants and children. Curr Allergy Asthma Rep 2014; 14 (12): 477.
16. Paul LP et al. Eur Res J 2014; 43 (4): 1172–7. http://erj.ersjournals.com/content/43/4/1172.
17. Guilbert TW, Morgan WJ, Zeiger RS et al. Long term inhaled corticosteroids in preschool children at high risk for asthma. N Eng J Med 2006; 354 (19): 1985–97.
18. Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics 2009; 123: e519–25.
19. Camargo CA, Ramachandran S, Ryskina KL et al. Association between common asthma therapies and recurrent asthma exacerbations in children enrolled in a state Medicaid plan. Am J Health Syst Pharmacy 2007; 64: 1054–61.
20. Boluyt N, Rottier BL, de Jongste JC et al. Assessment of controversial pediatric asthma management options using GRADE. Pediatrics 2012; 130: e658–e668. http://pediatrics.aappublications.org/content/130/3/e658?ijkey=31dccd4001bc31f79db1fa765e97dde9eb9f9...
________________________________________________
2. Ducharme FM, Tse SM, Chauhan B. Diagnosis, management, and prognosis of preschool wheeze. Lancet 2014; 383 (9928): 1593–604.
3. Cano-Garcinuño A, Mora-Gandarillas I; SLAM Study Group. Wheezing phenotypes in young children: an historical cohort study. Prim Care Respir J 2014; 23 (1): 60–6.
4. Just J, Saint-Pierre P, Amat F et al. What lessons can be learned about asthma phenotypes in children from cohort studies? Pediatr Allergy Immunol 2015; 26 (4): 300–5.
5. ERS Task Force, Brand P. Eur Respir J 2008; 32: 1096–110.
6. Just J, Saint-Pierre P, Gouvis-Echraghi R et al. Wheeze phenotypes in young children have different courses during the preschool period. Ann Allergy Asthma Immunol 2013; 111 (4): 256–61.
7. Raedler D, Ballenberger N, Klucker E et al. Identification of novel immune phenotypes for allergic and nonallergic childhood asthma. J Allergy Clin Immunol 2015; 135 (1): 81–91.
8. Castro-Rodriguez JA, Holberg C J, Wright AL, Martinez F D. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000; 162: 1403–6.
9. Bacharier LB, Boner A, Carlsen KH et al; European Pediatric Asthma Group. Diagnosis and treatment of asthma in childhood: a PRACTALL consensus report. Allergy 2008; 63 (1): 5–34.
10. Papadopoulos NG, Arakawa H, Carlsen KH et al. International consensus on (ICON) pediatric asthma. Allergy 2012; 67 (8): 976–97.
11. Global Initiative for Asthma (GINA). Pocket Guide for Asthma Management and Prevention in Children 5 Years and Younger, updated April 2015. Available from: http://www.ginasthma.org/local/uploads/files/GINA_PediatricPocket_2015.pdf.
12. Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика». Изд. 4-е. М., 2012. / Natsional'naia programma «Bronkhial'naia astma u detei. Strategiia lecheniia i profilaktika». Izd. 4-e. M., 2012. [in Russian]
13. Potter PC. Current guidelines for the management of asthma in young children. Allergy Asthma Immunol Res 2010; 2 (1): 1–13.
14. Durrani S, Guilbert TW. Early treatment in preschool children: an evidence-based approach. Curr Opin Allergy Clin Immunol 2015; 15 (2): 175–83.
15. Jackson DJ. Emerging issues in pediatric asthma: gaps in EPR-3 guidelines for infants and children. Curr Allergy Asthma Rep 2014; 14 (12): 477.
16. Paul LP et al. Eur Res J 2014; 43 (4): 1172–7. http://erj.ersjournals.com/content/43/4/1172.
17. Guilbert TW, Morgan WJ, Zeiger RS et al. Long term inhaled corticosteroids in preschool children at high risk for asthma. N Eng J Med 2006; 354 (19): 1985–97.
18. Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: a systematic review with meta-analysis. Pediatrics 2009; 123: e519–25.
19. Camargo CA, Ramachandran S, Ryskina KL et al. Association between common asthma therapies and recurrent asthma exacerbations in children enrolled in a state Medicaid plan. Am J Health Syst Pharmacy 2007; 64: 1054–61.
20. Boluyt N, Rottier BL, de Jongste JC et al. Assessment of controversial pediatric asthma management options using GRADE. Pediatrics 2012; 130: e658–e668. http://pediatrics.aappublications.org/content/130/3/e658?ijkey=31dccd4001bc31f79db1fa765e97dde9eb9f9...
Авторы
Н.А.Геппе*, Н.Г.Колосова
ФГБОУ ВО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*geppe@mma.ru
ФГБОУ ВО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*geppe@mma.ru
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N.A.Geppe*, N.G.Kolosova
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*geppe@mma.ru
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*geppe@mma.ru
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