docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2023-22-3-32-39docru-289Research ArticleПУЛЬМОНОЛОГИЯPULMONOLOGYВлияние карбоцистеина на выраженность кашля и компоненты местного иммунитета слизистых оболочек на фоне ОРВИ у детейCarbocysteine Influence on Cough Severity and Local Mucosal Immunity in Acute Respiratory Viral Infections in Childrenhttps://orcid.org/0000-0003-0547-3686ГеппеН. А.GeppeN. A.

Геппе Наталья Анатольевна — д. м. н., профессор, заведующая кафедрой детских болезней Клинического института детского здоровья имени Н.Ф. Филатова

119435, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119435

geppe@mail.ruhttps://orcid.org/0000-0001-6592-0121ВеликорецкаяМ. Д.VelikoretskayaM. D.

Великорецкая Марина Дмитриевна — к. м. н., доцент кафедры детских болезней Клинического института детского здоровья имени Н.Ф. Филатова

119435,  г. Москва, ул. Большая Пироговская, д. 19, стр. 1

 

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119435

marvek57@mail.ruhttps://orcid.org/0000-0001-6062-5334ОзерскаяИ. В.OzerskayaI. V.

Озерская Ирина Владимировна — к. м. н., доцент кафедры детских болезней Клинического института детского здоровья имени Н.Ф. Филатова

119435, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119435

ozerskaya_i_v@staff.sechenov.ruКожевниковаТ. Н.KozhevnikovaT. N.

Кожевникова Татьяна Николаевна — к. м. н., профессор кафедры педиатрии 

300012, г. Тула, пр-т Ленина, д. 92

92 Lenin Ave., Tula, 300012

pulmo71@yandex.ruФайзуллинаР. М.FaizullinaR. M.

Файзуллина Резеда Мансафовна — д. м. н., профессор кафедры факультетской педиатрии

450008, г. Уфа, ул. Ленина, д. 3

3 Lenin Str., Ufa, 450008

fayzullina@yandex.ruhttps://orcid.org/0000-0003-2085-0021ШаталинаС. И.ShatalinaS. I.

Шаталина Светлана Игоревна — к. м. н., ассистент кафедры детских болезней Клинического института детского здоровья имени Н.Ф. Филатова

119435, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119435

svetlanashatalina@mail.ruЗискинаН. К.ZiskinaN. K.

Зискина Надежда Константиновна — студентка 6-го курса Института клинической медицины имени Н.В. Склифосовского

119435, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119435

СидеркоЕ. А.SiderkoE. A.

Сидерко Екатерина Александровна — студентка 5-го курса Института клинической медицины имени Н.В. Склифосовского

119435, г. Москва, ул. Большая Пироговская, д. 19, стр. 1

19 Bolshaya Pirogovskaya Str., build. 1, Moscow, 119435

ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationФГБОУ ВО «Тульский государственный университет»РоссияTula State UniversityRussian FederationФГБОУ ВО «Башкирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияBashkir State Medical UniversityRussian Federation202320022025223ПЕДИАТРИЯ3239Copyright © Геппе Н.А., Великорецкая М.Д., Озерская И.В., Кожевникова Т.Н., Файзуллина Р.М., Шаталина С.И., Зискина Н.К., Сидерко Е.А., 20252025Геппе Н.А., Великорецкая М.Д., Озерская И.В., Кожевникова Т.Н., Файзуллина Р.М., Шаталина С.И., Зискина Н.К., Сидерко Е.А.Geppe N.A., Velikoretskaya M.D., Ozerskaya I.V., Kozhevnikova T.N., Faizullina R.M., Shatalina S.I., Ziskina N.K., Siderko E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/289Цель исследования

Цель исследования: оценить влияние карбоцистеина на течение кашля и уровень секреторного иммуноглобулина А (sIgA) в слюне у детей с острой респираторной вирусной инфекцией (ОРВИ) и наличие корреляции между уровнем sIgA в слюне и суммарным индексом кашля.

Дизайн

Дизайн: многоцентровое наблюдательное исследование.

Материалы и методы

Материалы и методы. В исследование включены 156 детей старше 2 лет (4,4 ± 1,2 года) с ОРВИ. Все пациенты получали карбоцистеин в возрастной дозировке. Суммарный индекс кашля и концентрацию sIgA в слюне измеряли на 1–2-е и на 7–10-е сутки от начала ОРВИ.

Результаты

Результаты. Суммарный индекс кашля значимо уменьшился у 98,7% пациентов к 7–10-му дню заболевания. Уровень sIgA в слюне исходно составлял 26,49 (8,94; 56,51) мкг/мл, в динамике — 30,07 (8,52; 60,40) мкг/мл (значимые различия не выявлены). Прирост уровня sIgA в динамике отмечен у 43,6% пациентов, при этом у подавляющего большинства он был существенным и составил 20% и более от исходного значения. Снижение концентрации sIgA в динамике наблюдалось у 55,8% пациентов, у одного (0,6%) ребенка динамика отсутствовала. Выявлена значимая корреляция между концентрациями sIgA в слюне на первом и втором визитах (p < 0,001). Значимая корреляция между суммарным индексом кашля и уровнем sIgA не найдена.

Заключение

Заключение. На фоне приема карбоцистеина отмечена существенная положительная динамика кашля. Концентрация sIgA в слюне и в норме, и на фоне ОРВИ варьирует в широких пределах. Изменения уровня sIgA в слюне в динамике у детей с ОРВИ были разнонаправленными. Дальнейшее изучение механизмов местного мукозального иммунитета может помочь в разработке подходов к лечению и профилактике ОРВИ.

Aim

Aim: To evaluate the effect of carbocysteine on cough and the level of secretory immunoglobulin A (sIgA) in saliva in children with acute respiratory viral infections (ARVI) and the presence of a correlation between the level of sIgA in saliva and the total cough index.

Design

Design: Multicentre observational study.

Materials and methods

Materials and methods. 156 children older than 2 years (4.4 ± 1.2 years) with ARVI were included in the study. All patients received carbocysteine at the age dosage. The total cough index and the concentration of sIgA in saliva were measured on days 1–2 and on days 7–10 from the onset of ARVI. Results. The total cough index significantly decreased in 98.7% of patients by the 7–10th day of illness. The level of sIgA in saliva was initially 26.49 (8.94; 56.51) µg/ml, in dynamics — 30.07 (8.52; 60.40) µg/ml (no significant differences were found). An increase in the level of sIgA in dynamics was noted in 43.6% of patients, and in the vast majority of them the increase was significant — 20% or more. A decrease in the concentration of sIgA in dynamics was noted in 55.8% of patients. A significant correlation was found between sIgA concentrations in saliva at the first and second visits (p < 0,001). There was no significant correlation between the total cough index and sIgA levels.

Conclusion

Conclusion. A significant positive dynamic of cough was noted in patients with ARVI during treatment with carbocysteine. The concentration of sIgA in saliva varies within a wide range. A multidirectional change in the level of sIgA in saliva over time was noted in children with ARVI. Further study of the mechanisms of local mucosal immunity can help in the development of new approaches to the treatment and prevention of ARVI.

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