Spirometric changes in children with asthma exposed to environmental tobacco smoke and treated with inhaled corticosteroids

Snezana Radic; Branislava Milenkovic; Branislav Gvozdenovic; Biljana Medjo; Sanja Dimic Janjic

doi:10.2298/VSP170306115R

Snezana Radic Klinika za pulmologiju, Klinicki Centar Srbije
Branislava Milenkovic Clinic for Pulmonary Diseases, Clinical Centre of Serbia, Belgrade, Serbia School of Medicine, University of Belgrade, Belgrade, Serbia
Branislav Gvozdenovic PPD Serbia, Pharmacovigilance Department, Belgrade, Serbia
Biljana Medjo University Children's Hospital, Belgrade, Serbia
Sanja Dimic Janjic Clinic for Pulmonary Diseases, Clinical Centre of Serbia, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170306115R

Ključne reči: astma, deca, predškolska, deca, adolescenti, roditelji, pušenje, zagađenje duvanskim dimom, respiratorna funkcija, testovi, flutikazon, inhalaciona primena

Sažetak

Apstrakt

Uvod/Cilj. Kortikosteroidi predstavljaju najčešće primenjivanu anti-inflamatornu terapiju u astmi. Cilj ovog istraživanja je bio da se uporede spirometrijski pokazatelji kao odgovor na terapiju inhalacionim flutikazon propionatom (FP) kod dece sa astmom, koja su izložena i koja nisu izložena duvanskom dimu (environmental tobacco smoke – ETS). Metode. Ispitivanjem je obuhvaćeno 527 dece uzrasta od jedne do 16 godina sa perzistentnom astmom, koja su podeljena u dve gupe: grupa izložena (exposed – E) duvanskom dimu (ETSE, n = 337) i ETSF grupa – deca neizložena duvanskom dimu (free – F, n = 190). Spirometrija je urađena pre propisivanja FP (1. set rezultata) i nakon 6 meseci primene FP (2. set rezultata). Dobra plućna funkcija (good lung function – GLF) je definisana kao forsirani ekspirijumski volumen u prvoj sekundi (FEV₁) ≥ 85%, a loša plućna funkcija (poor lung function – PLF) kao FEV₁ < 85%. Rezultati. Među ETSE decom, 208 je imalo jednog roditelja pušača, 129 je imalo dva, 228 je imalo majku pušača, a 238 oca pušača. ETSE deci je propisana veća doza FP (p < 0,0001), koja se povećavala sa povećanjem broja pušača u porodici. ETSE deca su imala značajno lošiju plućnu funkciju i u prvom i u drugom setu testova u odnosu na ETSF decu (p < 0,05). Nakon lečenja sa FP, obe grupe su poboljšale sve spirometrijske pokazatelje (p < 0,001). U drugom setu spirometrijskih testova, deca majki pušača imala su niže vrednosti spirometrijskih pokazatelja u odnosu na decu čiji su očevi pušači (p < 0,05). Procenat dece čija se plućna funkcija poboljšala od PLF do GLF nakon 6 meseci primene FP je bio mnogo veći među ETSF decom nego među decom 2. grupe ETSE (p < 0,05). Zaključak. Parametri plućne funkcije izmereni pre propisivanja FP su lošiji kod dece izložene duvanskom dimu, nego kod dece koja nisu izložena. Nakon šestomesečne primene FP poboljšani su parametri plućne funkcije kod obe ispitivane grupe, ali znatno više kod dece koja nisu bila izložena duvanskom dimu.

Reference

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Promene spirometrijskih pokazatelja kod dece sa astmom koja su izložena duvanskom dimu i lečena inhalacionim kortikosteroidima

Sažetak

Reference