medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2018-11-50-53medsovet-2500Research ArticleБРОНХОПУЛЬМОНОЛОГИЯ И ЛОРBRONCHIAL PULMONOLOGY AND ENTСистемные и ингаляционные глюкокортикостероиды при остром обструктивном ларинготрахеитеSystemic and inhaled glucocorticosteroids in acute obstructive laryngotracheitisЗайцеваО. В.ZaytsevaO. V.

д.м.н., профессор, заведующая кафедрой педиатрии ГБОУ ВПО «Московский государственный медикостоматологический университет им. А.И. Евдокимова» МЗ РФ, руководитель Университетской клиники педиатрии МГМСУ им. А.И. Евдокимова

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииРоссияA.I. Yevdokimov Moscow State University of Medicine and Dentistry, Federal State Budgetary Educational Institution of Higher Education of the Ministry of Health of RussiaRussian Federation2018150720180115053Copyright © Зайцева О.В., 20182018Зайцева О.В.Zaytseva O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2500

Острый обструктивный ларинготрахеит (круп) – распространенное заболевание детей первых лет жизни, возникающее на фоне острых респираторных вирусных инфекций (ОРВИ), наиболее часто на фоне парагриппа. Основным клиническим проя влением крупа является стеноз подскладочного пространства гортани, от степени которого зависит тяжесть заболевания. Основой лечения острого обструктивного ларинготрахеита является использование глюкокортикостероидов (ГКС), обладающих мощным противовоспалительным действием. Продолжительность терапии ГКС при крупе, как правило, не превышает нескольких дней. Однако даже короткие курсы системных ГКС сопровождаются развитием ряда нежелательных явлений: тошнота, рвота, нарушения поведения, расстройства сна и др. Согласно российским клиническим рекомендациям, первой линией терапии крупа является использование ингаляционного ГКС будесонида, ингаляции через небулайзер. Эффективность будесонида в терапии крупа подтверждена в ходе многочисленных клинических исследований. Ингаляционный способ доставки позволяет избежать побочных эффектов, присущих системным ГКС, при одинаковой клинической эффективности.

 

Acute laryngotracheitis (croup) is an acute condition that most commonly affects children of the first 6 years. Croup is caused by viral infection of the upper airway, predominantly by parainfluenza virus. Croup is characterized by the signs of subglottic stenosis, which determines croup severity. Corticosteroids are the mainstay of croup treatment due to a strong anti-inflammatory effect. Typically, duration of corticosteroid treatment in croup does not exce ed several days. Even short-course systemic corticosteroids are associated with a number of adverse effects: nausea, vomiting, behavioral changes and sleep disturbance, etc. According to Russian clinical guidelines for croup management inhaled corticosteroid budesonide is the first line therapy. Budesonide efficacy in croup has been proved in numerous clinical trials. Based on similar effectiveness of inhaled and systemic corticosteroids in croup patients, budesonide is the preferred treatment option, because it helps to minimize the risk of adverse effects.

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