ФАКТОРЫ РИСКА УВЕЛИЧЕНИЯ ОБЪЕМА ЛЕКАРСТВЕННОЙ ТЕРАПИИ У ПЕДИАТРИЧЕСКИХ ПАЦИЕНТОВ С БРОНХИАЛЬНОЙ АСТМОЙ (ПО РЕЗУЛЬТАТАМ ДЕСЯТИЛЕТНЕГО ПРОСПЕКТИВНОГО НАБЛЮДЕНИЯ)

Abstract

The study aims to determine the anamnestic, functional, and laboratory factors affecting the load of basic drug therapy in children with bronchial asthma during a ten-year regular dynamic monitoring of their height, body weight, spirometry data, the nature of the ongoing treatment of asthma, and the drug doses. An open, prospective monitoring trial included 131 patients, each of whom attended a hospital at least 20 times every 6 months. The data obtained was not used to correct the therapy method and regular medical check-up. By the end of the tenth year, 98 patients had demonstrated the following results: 57.1 % of children maintained a stable load of basic therapy, while the load of drug therapy was increased in 24.5 % of patients, and decreased in 18.4 % of them. The likelihood of a drug load reduction was statistically significantly reduced in patients with a body mass index greater than 90 weight percentile for 18 months or longer in comparison with patients who had never been overweight. Patients with the obstructive disorders detected with spirometry during two or more consecutive visits had a statistically significantly higher risk of drug therapy overload or a lower likelihood of its reduction in comparison with those without any external respiration malfunctions. The allergen-specific therapy made it possible to significantly lower the risk of drug overload and increase the possibility of its reduction. The allergen-specific immunotherapy, body weight management, and absence of obstructive disorders in spirometry all contribute to reducing the drug therapy load while maintaining a controlled course of the disease.