medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-1-203-212medsovet-6048Research ArticleАЛЛЕРГОЛОГИЯ И ИММУНОЛОГИЯALLERGOLOGY AND IMMUNOLOGYВсегда ли легко детям с легкой астмой?Is it always easy for children with mild asthma?https://orcid.org/0000-0002-4908-6146ГлушковаЕ. Ф.GlushkovaEvgeniya F.

 Глушкова Евгения Федоровна, врач аллерголог-иммунолог поликлинического отделения

115522,  Москва, Каширское шоссе, д. 24

  Evgeniya F. Glushkova, Allergist-Immunologist, Outpatient Department

24, Kashirskoye Shosse, Moscow, 115522

glushkovaef@gmail.comhttps://orcid.org/0000-0001-7676-3213СуровенкоТ. Н.SurovenkoTatiana N.

 Суровенко Татьяна Николаевна, д.м.н., профессор Института педиатрии

690002, Владивосток, ул. Острякова, д. 2

 Tatiana N. Surovenko, Dr. of Sci. (Med.), Professor of Institute of Pediatrics

2, Ostriakova St., Vladivostok, 690002

Tatiana.surovenko@gmail.comГосударственный научный центр «Институт иммунологии»РоссияNational Research Center – Institute of ImmunologyRussian FederationТихоокеанский государственный медицинский университетРоссияPacific State Medical UniversityRussian Federation20212003202101203212Copyright © Глушкова Е.Ф., Суровенко Т.Н., 20212021Глушкова Е.Ф., Суровенко Т.Н.Glushkova E.F., Surovenko T.N.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/6048

Бронхиальная астма – самая распространенная хроническая болезнь среди детей, существенным образом ухудшающая их качество жизни.

Комплаентность в случае лечения детей очень важна, поскольку фактическое действие лекарства определяется как эффективностью лекарства, так и приверженностью пациента и правильным его применением. Актуальной клинической задачей является подбор препарата для базисной терапии легкой астмы, способной контролировать гиперреактивность бронхов при астме, связанной с физической нагрузкой, холодным или сухим воздухом, другими неспецифическими раздражителями (дымом, запахами и т. д.). Особую трудность для педиатров представляет планирование базисной терапии детей с легкой астмой в возрасте 5 лет и младше в связи с их частой заболеваемостью острыми респираторно-вирусными заболеваниями и обострениями бронхиальной астмы, связанными с вирусной инфекцией. Детям этого возраста не рекомендована аллерген-специфическая иммунотерапия, В-агонисты длительного действия, применение многих дозированных ингаляционных глюкокортикостероидов.

Монтелукаст, пероральный АЛП, имеет определенные преимущества при лечении детей с легкой астмой с вирус-индуцированными обострениями, при астме физического усилия и выраженной гиперреактивности бронхов, особенно при сочетании с аллергическим ринитом, а также в особых клинических ситуациях, к примеру при отказе родителей использовать ингаляционные глюкокортикостероиды для лечения детей с легкой астмой или невозможности их использования по какой-то причине. Применение монтелукаста при легкой астме у детей в современных условиях пандемии COVID-19 также имеет свои преимущества, которые могут использовать педиатры при наблюдении этих детей на педиатрическом участке с учетом показаний и противопоказаний.

Bronchial asthma is the most common chronic disease of children, the worst way is their quality of life. Compliance in the treatment of children is very important, since the actual effect of a drug is determined by both the effective drugs and patient adherence and correct use. A relevant test is the use of mild asthma, which is able to control bronchial hyperreactivity associated with exercise, cold air, and other nonspecific irritants (smoke, odors, etc.). Planning of baseline therapy for children with mild asthma aged 5 years old and younger is particularly problematic for paediatricians due to high incidences of acute respiratory viral diseases and viral-induced exacerbations of bronchial asthma among them. In these children, allergen-specific immunotherapy, long-acting B-agonists, the use of many metered-dose inhaled glucocorticosteroids. are not recommended.

Montelukast, an oral antileukotriene drug, has advantages in the treatment of children with mild asthma with virus-induced exacerbations, with asthma of physical exertion and severe bronchial hyperreactivity, especially when combined with allergic rhinitis, as well as in special clinical cases, when parents refuse to use ICS for treatment children with mild asthma or inability to use them for some reason. The use of montelukast for mild asthma in children in the current context of the COVID-19 pandemic also has advantages that pediatricians can use when observing these children in the pediatric area, taking into account contraindications.

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