pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2019-29-4-411-418pulmo-1193Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESБронхиальная астма у детей дошкольного возраста, проживающих в городских условиях Алтайского края (популяционное одномоментное исследование)Bronchial asthma in pre-school children living in urban areas of the Altay Krai: a population-based cross-sectional studyhttps://orcid.org/0000-0002-7143-8259ШаховаН. В.ShakhovaN. V.

Шахова Наталья Викторовна – кандидат медицинских наук, врач аллерголог-иммунолог высшей квалификационной категории, доцент кафедры пропедевтики детских болезней

656038, Алтайский край, Барнаул, пр-т Ленина, 40

 

Natal’ya V. Shakhova, Candidate of Medicine, allergologist, immunologist, Associate Professor, Department of Propaedeutics of Pediatric Diseases

pr. Lenina 40, Barnaul, 656060

 

Natalia.shakhova@mail.ruhttps://orcid.org/0000-0002-2234-5355КамалтыноваЕ. М.KamaltynovaE. M.

Камалтынова Елена Михайловна – доктор медицинских наук, доцент кафедры факультетской педиатрии с курсом детских болезней лечебного факультета

634050, Томск, Московский тракт, 2

 

 

Elena M. Kamaltynova, Doctor of Medicine, Associate Professor, Department of General Internal Medicine with the Course of Pediatric Diseases

Moskovskiy tract 2, Tomsk, 634050

eleant21@yandex.ruhttps://orcid.org/0000-0001-7801-0223ЛобановЮ. Ф.LobanovYu. F.

Лобанов Юрий Федорович – доктор медицинских наук, профессор, заведующий кафедрой пропедевтики детских болезней

656038, Алтайский край, Барнаул, пр-т Ленина, 40

Yuriy F. Lobanov, Doctor of Medicine, Professor, Head of Department of Propaedeutics of Pediatric Diseases

pr. Lenina 40, Barnaul, 656060

luf@list.ruhttps://orcid.org/0000-0001-8184-9230КашинскаяТ. С.KashinskayaT. S.

Кашинская Татьяна Сергеевна – ассистент кафедры пропедевтики детских болезней

656038, Алтайский край, Барнаул, пр-т Ленина, 40

Tat’yana S. Kashinskaya, Assistant Lecturer, Department of Propaedeutics of Pediatric Diseases

pr. Lenina 40, Barnaul, 656060

 

ardatova_agmu@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Алтайский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияAltay State Medical University, Healthcare Ministry of RussiaRussian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Сибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal Siberian State Medical University, Healthcare Ministry of RussiRussian Federation201924102019294411418Copyright © Шахова Н.В., Камалтынова Е.М., Лобанов Ю.Ф., Кашинская Т.С., 20192019Шахова Н.В., Камалтынова Е.М., Лобанов Ю.Ф., Кашинская Т.С.Shakhova N.V., Kamaltynova E.M., Lobanov Y.F., Kashinskaya T.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.pulmonology.ru/pulm/article/view/1193

Для формирования стратегии ранней профилактики бронхиальной астмы (БА) необходимо изучение распространенности и факторов риска (ФР) заболевания среди дошкольников. Целью исследования явилось изучение распространенности, клинико-аллергологической характеристики и ФР развития БА у детей 3–6 лет, проживающих в городских условиях Алтайского края. Материалы и методы. Проведено одномоментное популяционное исследование, состоявшее из 2 этапов – скринингового и клинического. На этапе скрининга в исследование включены дети (n = 3 205) в возрасте 3–6 лет, посещающие дошкольные образовательные учреждения в 5 городах Алтайского края. Симптомы БА определялись при помощи модуля «Астмоподобные симптомы», входящего в опросник «Международное исследование бронхиальной астмы и аллергии у детей» (International Study of Asthma and Allergies in Childhood – ISAAC). На клиническом этапе диагноз БА верифицировался врачами-аллергологами на основании диагностических критериев Глобальной инициативы по бронхиальной астме (Global Strategy for Asthma Management and Prevention – GINA). Результаты. Установлено, что распространенность БА среди городских детей в возрасте 3–6 лет составляет 5,7 %, из них у 62,7 % диагноз БА был установлен ранее в учреждениях практического здравоохранения. У 76 (59,4 %) выявлена БА легкой степени. У 90 (70,3 %) детей выявлена сенсибилизация. Чаще всего (63,3 %) обнаруживалась сенсибилизация к клещам домашней пыли (Dermatophagoides pteronyssinus), пыльце березы (46,6 %) и эпителию кошки (31,1 %). ФР развития БА являются семейный аллергологический анамнез (отношение шансов (ОШ) – 3,2; 95%-ный доверительный интервал (ДИ) – 2,2–4,6) мужской пол (ОШ – 2,2; 95%-ный ДИ – 1,5–2,3), недоношенность (ОШ – 2,1; 95%-ный ДИ – 1,3–3,3), табакокурение родителей (ОШ – 1,6; 95%-ный ДИ 1,2–2,9), контакт с животными на 1-м году жизни (ОШ – 1,4; 95%-ный ДИ – 1,0–2,0). Заключение. Распространенность БА среди детей 3–6 лет, проживающих в городах Алтайского края, составляет 5,7 %, в то время как ранее в учреждениях практического здравоохранения диагноз БА установлен только у 62,7 % детей. Наиболее значимыми ингаляционными аллергенами являются клещи домашней пыли, пыльца березы и эпителий кошки. ФР развития БА в дошкольном возрасте являются мужской пол, отягощенный аллергологический семейный анамнез, недоношенность, пассивное курение и контакт с животными на 1-м году жизни.

The objective of the study was to investigate prevalence, clinical and allergological features, and risk factors of bronchial asthma in pre-school children living in urban areas of Altay Krai. Methods. This was a cross-sectional study involving 3,205 children (age, 3 to 6 years) attending pre-school facilities in 5 cities of the Altay Krai. Asthma symptoms were defined using the ISAAC questionnaire. Asthma was diagnosed by clinicians according to GINA. Results. Prevalence of asthma in urban children aged 3 to 6 years was 5.7%; 62.7% of them were previously diagnosed with asthma. Majority of children (59.4%) had mild asthma. Sensitization was detected in 70.3% of children with asthma, most of them were sensitized to dust mites Dermatophagoides pteronyssinus (63.3%), birch pollen (46.6%), and cat epithelium (31.1%). Risk factors of asthma were family history of allergy [odds ratio (OR) 3.2; 95% confidence interval (CI) 2.2–4.6], male gender (OR 2.2, 95% CI 1.5–2.3), preterm birth (OR 2.1, 95% CI 1.3–3.3), smoking parents (OR 1.6, 95% CI 1.2–2.9), (contact with pets during the first year of life (OR 1.4, 95% CI 1.0–2.0). Conclusion. The prevalence of asthma in urban children aged 3 to 6 years living in urban areas of Altay Krai was 5.7%. Most common sensitizers were house dust mites, birch pollen and cat epithelium. The risk factors of pre-school asthma are family history of allergy, male gender, preterm birth, passive smoking and contact with pets during the first year of life.

 

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