Koloskova Olena, Bilous Tetiana, Bilyk Galyna, Buryniuk-Glovyak Kristina, Korotun Olena, Shchudrova Tetiana
Higher State Educational Establishment «Bukovinian State Medical University», Chernivtsi, Ukraine.
Wiad Lek. 2020;73(1):31-35.
The aim: To study the clinical and spirographic features persistence of the bronchial asthma in schoolchildren against the background of the alternative daily doses of inhaled corticosteroids to increase the effectiveness of anti-inflammatory therapy for this disease.
Materials and methods: A complete comprehensive clinical-paraclinical examination of 65 schoolchildren with persistent asthma was conducted. According to the average daily dose of inhaled corticosteroids (ICS) the patients were divided into two clinical groups. The first (I) group consisted of 46 children who received ICS in the regimen of low-to-medium equipotent doses (253.95±9.98 μg per day), and the second (II) comparison group was formed of 19 patients who controlled the pBA using high doses of ICS (494.74±5.56 μg per day).
Results: The patients of the І clinical group compared to patients of the ІІ group have a higher risk of the mild bronchial obstructive syndrome during asthma attacks. In assessing the level of control of persistent bronchial asthma using the CIA-scale, it was found that in II group cases of the controlled course of the disease were observed almost two times less than in children of the I group of comparison. In conducting spirography in children of comparison groups, it was shown that the ratio of indices of bronchospasm (FEV1/FVC) was worse in patients receiving high doses of ICS.
Conclusions: So, сharacteristic clinical feature of asthma controlled by high doses of ICS is more severe nature of bronchial obstructive syndrome during the period of exacerbation (OR=1.9-3.0). In the management of persistent bronchial asthma, the Gensler index which has high specificity (94.4%) and accuracy (92.2%) should be used for disease control verification.
研究学龄期儿童支气管哮喘在每日交替使用吸入性糖皮质激素背景下的临床和肺功能特征，以提高该疾病抗炎治疗的效果。
材料与方法：对65名持续性哮喘学龄儿童进行了全面的临床-辅助检查。根据吸入性糖皮质激素（ICS）的平均日剂量，将患者分为两个临床组。第一（I）组由46名儿童组成，他们接受低至中等等效剂量（每天253.95±9.98μg）的ICS治疗，第二（II）对照组由19名使用高剂量ICS（每天494.74±5.56μg）控制pBA的患者组成。
结果：与II组患者相比，I临床组患者在哮喘发作时发生轻度支气管阻塞综合征的风险更高。使用CIA量表评估持续性支气管哮喘的控制水平时发现，II组疾病得到控制的病例数比I对照组儿童少近两倍。在对对照组儿童进行肺功能检查时发现，接受高剂量ICS的患者支气管痉挛指数（FEV1/FVC）更差。
结论：因此，高剂量ICS控制的哮喘的特征性临床特征是在加重期支气管阻塞综合征的性质更严重（OR = 1.9 - 3.0）。在持续性支气管哮喘的管理中，应使用具有高特异性（94.4%）和准确性（92.2%）的Gensler指数来验证疾病控制情况。
