pulmoПульмонологияPULMONOLOGIYA0869-01892541-9617Scientific and Practical Journal “PULMONOLOGIYA” LLC10.18093/0869-0189-2017-27-6-781-788pulmo-946Research ArticleОБЗОРЫREVIEWЕстественное течение бронхиальной астмы: гендерный аспектGender aspects of natural course of asthmaКобяковаО. С.KobyakovaO. S.

Кобякова Ольга Сергеевна – доктор медицинских наук, профессор, заведующая кафедрой общей врачебной практики и поликлинической терапии 

634050, Томск, Московский тракт, 2

Ol'ga S. Kobyakova, Doctor of Medicine, Professor, Head of Department of General Practice and Outpatient Therapy 

Moskovskiy tract 2, Tomsk, 634050, Russia

olga_kobyakova@rambler.ruКуликовЕ. С.KulikovE. S.

Куликов Евгений Сергеевич – доцент кафедры общей врачебной практики и поликлинической терапии 

634050, Томск, Московский тракт, 2

Evgeniy S. Kulikov, Associate Professor, Department of General Practice and Outpatient Therapy 

Moskovskiy tract 2, Tomsk, 634050, Russia

evgeny.s.kulikov@gmail.comДеевИ. А.DeevI. A.

Деев Иван Анатольевич – доктор медицинских наук, профессор кафедры факультетской педиатрии с курсом детских болезней лечебного факультета 

634050, Томск, Московский тракт, 2

Ivan A. Deev, Doctor of Medicine, Professor, Department of General Pediatric Diseases with Course in Pediatric Diseases, Therapeutic Faculty 

Moskovskiy tract 2, Tomsk, 634050, Russia

ivandeyev@yandex.ruПименовИ. Д.PimenovI. D.

Пименов Игорь Дмитриевич – ординатор кафедры общей врачебной практики и поликлинической терапии 

634050, Томск, Московский тракт, 2

Igor' D. Pimenov, Resident Physician, Department of General Practice and Outpatient Therapy 

Moskovskiy tract 2, Tomsk, 634050, Russia

igor.d.pimenov@gmail.comКоломеецИ. Л.KolomeetsI. L.

Коломеец Иван Леонидович – аспирант кафедры факультетской педиатрии с курсом детских болезней лечебного факультета 

634050, Томск, Московский тракт, 2

 

Ivan L. Kolomeets, Postgraduate student, Department of General Pediatric Diseases with Course in Pediatric Diseases, Therapeutic Faculty 

Moskovskiy tract 2, Tomsk, 634050, Russia

ivan.l.kolomeets@gmail.comФедеральное государственное бюджетное образовательное учреждение высшего образования «Сибирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSiberian State Medical University, Healthcare Ministry of RussiaRussian Federation201723022018276781788Copyright © Кобякова О.С., Куликов Е.С., Деев И.А., Пименов И.Д., Коломеец И.Л., 20182018Кобякова О.С., Куликов Е.С., Деев И.А., Пименов И.Д., Коломеец И.Л.Kobyakova O.S., Kulikov E.S., Deev I.A., Pimenov I.D., Kolomeets I.L.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/946

Существующие на сегодняшний день исследования, посвященные гендерному аспекту естественного течения бронхиальной астмы (БА), являются противоречивыми и не позволяют определенно судить о влиянии пола при данном заболевании. Тем не менее в большинстве исследований продемонстрирован постепенный рост распространенности симптомов и частоты встречаемости БА среди девочек. В ряде исследований показано влияние гендерного аспекта на заболеваемость БА. Так, среди взрослых пациентов, достигших 40 лет, верифицированный диагноз БА намного чаще встречается у женщин. Кроме того, по данным мировых исследований, женский пол также является независимым фактором риска развития неаллергической БА. По сравнению с мужчинами, среди лиц женского пола установлен более высокий уровень заболеваемости и распространенности БА, а также более тяжелое естественное ее течение. Гендерные различия в частоте госпитализаций при БА продемонстрированы также и в зарубежных исследованиях. Так, до 12 лет мальчики чаще получают лечение в стационаре по поводу БА, в то время как девочки достоверно чаще госпитализируются после пубертатного периода и нуждаются в использовании препаратов скорой помощи для купирования приступов БА. Тенденция к более тяжелому течению БА сохраняется и во взрослом возрасте.

По результатам проведенного обзора можно заключить, что гендерные различия в естественном течении БА начинают проявляться в период пубертата, могут быть объяснены анатомическими особенностями развития дыхательной системы и гормональной перестройкой женского организма, что проявляется большей выраженностью гиперреактивности дыхательных путей и, как следствие, высокой частотой неконтролируемого течения БА.

Published studies on gender aspects of the natural course of asthma are controversial and do not give information on gender difference of asthma. However, most studies showed a gradual increase in prevalence of asthma symptoms and morbidity in girls. Gender difference in asthma course was shown in several studies. In patients older 40 years, asthma was confirmed in women significantly more often. Female gender was shown to be an independent risk factor of non-allergic asthma. Natural course of asthma in females was more severe than in males. Gender difference is also related to a rate of hospitalization due to asthma. Hospitalizations due to asthma and need in reliever medications are more often in boys younger 12 years and in girls after puberty. This tendency maintains in adults.

According to this review, one can conclude that gender difference in the natural course of asthma appears in puberty and could be explained by gender difference in anatomy of the airways and endocrine system that could lead to more prominent bronchial hyperreactivity and, as a result, worse asthma control.

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