pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLCpulmo-2801Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL STUDIESИнгаляционные кортикостероиды (пульмикорт) для небулайзерной терапии у детейInhaled corticosteroids (Pulmicort) for nebulized therapy of childrenГеппеН. А.GeppeN. A.СеливерстоваН. А.SeliverstovaN. A.МалаховА. Б.MalakhovA. B.ЛисицынМ. Н.LisitsinM. N.СнегоцкаяМ. Н.SnegotskayaM. N.МалышевВ. С.MalyshevV. S.Московская медицинская академия им.И.М.СеченоваRussian Federation200130062001027479Copyright © Геппе Н.А., Селиверстова Н.А., Малахов А.Б., Лисицын М.Н., Снегоцкая М.Н., Малышев В.С., 20012001Геппе Н.А., Селиверстова Н.А., Малахов А.Б., Лисицын М.Н., Снегоцкая М.Н., Малышев В.С.Geppe N.A., Seliverstova N.A., Malakhov A.B., Lisitsin M.N., Snegotskaya M.N., Malyshev V.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/2801

В работе изучалась возможность применения ингаляционного кортикостероида будесонида (пульмикорт) в суспензии для небулайзера при обострении бронхиальной астмы у детей. Проводилось обследование 92 детей со среднетяжелой и тяжелой бронхиальной астмой в возрасте от 1,5 до 14 лет и 1 ребенка 6 лет со стенозирующим ларинготрахеитом. Оценивались клинические данные, проводились спирографическое исследование, бронхофонография.

У 78 (84,8%) детей наблюдалось улучшение состояния в 1-е или 2-е сутки после ингаляций бронхоспазмолитика (беродуал в возрастной дозировке). Недостаточный эффект от бронхоспазмолитической терапии был у 14 (15,2%) детей. Дети были разделены на 2 группы: 8 детям были включены в лечение системные глюкокортикостероиды в дозе 2 мг/кг, 6 детей получали суспензию пульмикорта через небулайзер в дозе 0,5-1 мг 2 раза в день в течение 2-5 дней. В обеих группах состояние детей на 2-й день лечения стабилизировалось. При назначении системных стероидов улучшение было более медленным, чем при назначении пульмикорта.

This work assessed possibilities of using the inhaled nebulized corticosteroid budesonide (Pulmicort) in bronchial asthma exacerbation children. The study involved 92 children with moderate to severe bronchial asthma aged 1.5 to 14 years and one child with stenosing laryngotracheitis. Clinical data, spirography and bronchophonography results were analyzed.

Seventy eight (84.8%) children improved their condition in 1 or 2 days after inhalations of bronchodilator (berodual in doses according to the patients’ age). Insufficient bronchodilating effect was in 14 (15.2%) children. The children were divided into 2 groups: 8 of them were treated with systemic corticosteroids 2 mg/kg and 6 ones were given Pulmicort suspension via nebulizer 0.5-1 mg twice a day during 2-5 days. The children's condition became stable in both of the groups in 2 days. The children received systemic steroids improved more slowly than those given Pulmicort.

So, nebulized Pulmicort suspension demonstrates its high efficiency especially in infants and pre-school children. The nebulized therapy allows achieving the result faster than systemic steroids do. Any adverse effects of Pulmicort were noted.

ReferencesНеотложная терапия бронхиальной астмы у детей / Баранов А.А., Геппе Н.А., Коростовцев Д.С. и др. М.; 1999.Неотложная терапия бронхиальной астмы у детей / Баранов А.А., Геппе Н.А., Коростовцев Д.С. и др. М.; 1999.Геппе НА., Карпут кина А.В., Большакова Т.Д. и др. Ингаляционные кортикостероидные препараты при бронхиальной астме у детей. Вестн. перинатол. и педиат. 1997; 4: 39-43.Геппе НА., Карпут кина А.В., Большакова Т.Д. и др. Ингаляционные кортикостероидные препараты при бронхиальной астме у детей. Вестн. перинатол. и педиат. 1997; 4: 39-43.Демент ьева Г.М., Малышев B.C. Акустические характеристики дыхательных шумов у здоровых доношенных детей в течение раннего неонатального периода. Вестн. Рос. ассоциации акушеров-гинекологов 1996; 4: 22-27.Демент ьева Г.М., Малышев B.C. Акустические характеристики дыхательных шумов у здоровых доношенных детей в течение раннего неонатального периода. Вестн. Рос. ассоциации акушеров-гинекологов 1996; 4: 22-27.Бронхиальная астма у детей. Стратегия лечения и профилактика. Национальная программа. М.; 1997.Бронхиальная астма у детей. Стратегия лечения и профилактика. Национальная программа. М.; 1997.Agertoft L., Andersen A., Weibull Е. et al. Systemic availability and pharmacokinetics of nebulised budesonide in preschool children. Arch. Dis. Child. 1999; 80: 241-247.Agertoft L., Andersen A., Weibull Е. et al. Systemic availability and pharmacokinetics of nebulised budesonide in preschool children. Arch. Dis. Child. 1999; 80: 241-247.Agertoft L., Pedersen S. Final height of asthmatic children treated for 7-11 years with inhaled budesonide. Am. J. Respir. Crit. Care Med. 1998; 157 (3): A 711.Agertoft L., Pedersen S. Final height of asthmatic children treated for 7-11 years with inhaled budesonide. Am. J. Respir. Crit. Care Med. 1998; 157 (3): A 711.Baker J.W., Mellon М., Wald J. et al. Multiple-dosing, placebocontrolled study of budesonide inhalation suspension given once or twice daily for treatment of persistent asthma in young children and infants. Pediatrics 1999; 103: 414-421.Baker J.W., Mellon М., Wald J. et al. Multiple-dosing, placebocontrolled study of budesonide inhalation suspension given once or twice daily for treatment of persistent asthma in young children and infants. Pediatrics 1999; 103: 414-421.Curtis P. Comparison of prednisolone and nebulized budesonide in acute asthma in children: a pilot study. Eur. Respir. J. 1995; 8 (suppl. 19): 470S.Curtis P. Comparison of prednisolone and nebulized budesonide in acute asthma in children: a pilot study. Eur. Respir. J. 1995; 8 (suppl. 19): 470S.Daughbjerg P., Brenoe E., Forchhammer H. et al. A comparison between nebulised terbutaline, nebulised corticosteroid and systemic corticosteroid for acute wheezing in children up to 18 months of age. Acta Paediat. 1993; 82: 547-551.Daughbjerg P., Brenoe E., Forchhammer H. et al. A comparison between nebulised terbutaline, nebulised corticosteroid and systemic corticosteroid for acute wheezing in children up to 18 months of age. Acta Paediat. 1993; 82: 547-551.De Blic J., Delacourt C., Le Bourigeois M. et al. Efficacy of nebulized budesonide in treatment of severe infantile asthma: a double-blind study. J. Allergy Clin. Immunol. 1996; 98: 14-20.De Blic J., Delacourt C., Le Bourigeois M. et al. Efficacy of nebulized budesonide in treatment of severe infantile asthma: a double-blind study. J. Allergy Clin. Immunol. 1996; 98: 14-20.Geelhoed G.C., Macdonald W.B.G. Oral and inhaled steroids in croup: a randomized, placebo-controlled trial. Paediatr. Pulmonol. 1995a; 20: 355-361.Geelhoed G.C., Macdonald W.B.G. Oral and inhaled steroids in croup: a randomized, placebo-controlled trial. Paediatr. Pulmonol. 1995a; 20: 355-361.Georgiiis J. A study of once-a-day budesonide nebulizing suspension (BNS) and placebo (PBO) in asthmatic children aged six months to eight years. Chest 1997; 112: 37S.Georgiiis J. A study of once-a-day budesonide nebulizing suspension (BNS) and placebo (PBO) in asthmatic children aged six months to eight years. Chest 1997; 112: 37S.Godden C.W., Campbell M.J., Hussey M. et al. Double blind placebo controlled trial of nebulised budesonide for croup. Arch. Dis. Child. 1997; 76: 155-158.Godden C.W., Campbell M.J., Hussey M. et al. Double blind placebo controlled trial of nebulised budesonide for croup. Arch. Dis. Child. 1997; 76: 155-158.Godfrey S., A r ita l A., Rosier A. et al. Nebulized budesonide in severe infantile asthma. Lancet 1987; 2: 851-852.Godfrey S., A r ita l A., Rosier A. et al. Nebulized budesonide in severe infantile asthma. Lancet 1987; 2: 851-852.Grimfeld A., Lesbros D., Ostinelli J. et al. Long term study of nebulized budesonide in young children with moderate to severe asthma. Eur. Respir. J. 1994, 7 (suppl. 18): 27S.Grimfeld A., Lesbros D., Ostinelli J. et al. Long term study of nebulized budesonide in young children with moderate to severe asthma. Eur. Respir. J. 1994, 7 (suppl. 18): 27S.Husby S., Agertoft L., Mortensen S., Pedersen S. Treatment of croup with nebulised steroid (budesonide): a double blind, placebo controlled study. Arch. Dis. Child. 1993; 68: 352-355.Husby S., Agertoft L., Mortensen S., Pedersen S. Treatment of croup with nebulised steroid (budesonide): a double blind, placebo controlled study. Arch. Dis. Child. 1993; 68: 352-355.Illangovan P., Pedersen S., Godfrey J. et al. Treatment of severe steroid-dependent preschool asthma with nebulized budesonide suspension. Arch. Dis. Child. 1993; 68: 356-359.Illangovan P., Pedersen S., Godfrey J. et al. Treatment of severe steroid-dependent preschool asthma with nebulized budesonide suspension. Arch. Dis. Child. 1993; 68: 356-359.Kemp J.S., Skoner D.P., Szefler S.J. et al. Once-daily budesonide inhalation suspension for the treatment of persistent asthma in infants and young children. Ann. Allergy Asthma Immunol. 1999; 83: 231-239.Kemp J.S., Skoner D.P., Szefler S.J. et al. Once-daily budesonide inhalation suspension for the treatment of persistent asthma in infants and young children. Ann. Allergy Asthma Immunol. 1999; 83: 231-239.Maayan C., Itzhaki J., Bar-Gishay E. et al. The functional response of infants with persistent wheezing to nebuilized beclomethasone dipropionate. Paediatr. Pulmonol. 1986; 2: 9-14.Maayan C., Itzhaki J., Bar-Gishay E. et al. The functional response of infants with persistent wheezing to nebuilized beclomethasone dipropionate. Paediatr. Pulmonol. 1986; 2: 9-14.Otulana B.A., Varma N., Bullock A. et al. High dose nebulized steroid in the treatment of chronic asthma. Respir. Med 1992* 86: 105-108.Otulana B.A., Varma N., Bullock A. et al. High dose nebulized steroid in the treatment of chronic asthma. Respir. Med 1992* 86: 105-108.Pedersen S., Steffensen G., Ekman J. et al. Pharmacokinetics of budesonide in children with asthma. Eur. J. Clin. Pharmacol. 1987; 31: 579-582.Pedersen S., Steffensen G., Ekman J. et al. Pharmacokinetics of budesonide in children with asthma. Eur. J. Clin. Pharmacol. 1987; 31: 579-582.Scott М., Ellis М., Cruz-Rivera M. et al. Improved asthma control with once-daily budesonide inhalation suspension (BIS; Pulmicort Respules) in children <4 and >4 years of age. J. Allergy Clin. Immunol. 1999; 103 (№ 1, pt 2): S 130.Scott М., Ellis М., Cruz-Rivera M. et al. Improved asthma control with once-daily budesonide inhalation suspension (BIS; Pulmicort Respules) in children <4 and >4 years of age. J. Allergy Clin. Immunol. 1999; 103 (№ 1, pt 2): S 130.Shapiro G., Mendelson L., Kraemer M. J. et al. Efficacy and safety of budesonide inhalation suspension (Pulmicort Respules) in young children with inhaled steroid-dependent, persistent asthma. Ibid. 1998; 102: 789-796.Shapiro G., Mendelson L., Kraemer M. J. et al. Efficacy and safety of budesonide inhalation suspension (Pulmicort Respules) in young children with inhaled steroid-dependent, persistent asthma. Ibid. 1998; 102: 789-796.Webb M.S.C., M iln e r A.D., H i lle r E.J. et al. Nebulized beclamethasone dipropionate suspension. Arch. Dis. Child. 1986; 61: 1108-1110.Webb M.S.C., M iln e r A.D., H i lle r E.J. et al. Nebulized beclamethasone dipropionate suspension. Arch. Dis. Child. 1986; 61: 1108-1110.Wennergren G., Nordvall S.L., Hedin G. et al. Nebulized budesonide for the treatment of moderate to severe asthma in infants and toddlers. Acta Paediatr. 1996; 85: 183-189.Wennergren G., Nordvall S.L., Hedin G. et al. Nebulized budesonide for the treatment of moderate to severe asthma in infants and toddlers. Acta Paediatr. 1996; 85: 183-189.

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