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Vojnosanitetski pregled
2019, vol. 76, br. 3, str. 321-330
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP170306115R
Creative Commons License 4.0
Promene spirometrijskih pokazatelja kod dece sa astmom koja su izložena duvanskom dimu i lečena inhalacionim kortikosteroidima
aUniverzitet u Beogradu, Medicinski fakultet, KBC 'Dr Dragiša Mišović'
bClinical Centre of Serbia, Clinic for Pulmonary Diseases, Belgrade + University of Belgrade, Faculty of Medicine, Belgrade
cPPD Serbia, Pharmacovigilance Department, Belgrade
dUniversity of Belgrade, Faculty of Medicine, Belgrade + University Children's Hospital, Belgrade
eClinical Centre of Serbia, Clinic for Pulmonary Diseases, Belgrade

e-adresa: snezana_radic@hotmail.com

Projekat

Retke bolesti: molekularna patofiziologija, dijagnostički i terapijski modaliteti i socijalni, etički i pravni aspekti (MPNTR - 41004)

Sažetak

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.

Ključne reči

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