МЕСТО ТОПИЧЕСКОЙ СТЕРОИДНОЙ ТЕРАПИИ В ЛЕЧЕНИИ ОСТРОГО РИНОСИНУСИТА

СтатьяМЕД СОВЕТ. 2017; № 16: 18–23. DOI:10.21518/2079-701X-2017-16-18-23

Косяков С.Я.^[1]

Минавнина Ю.В.^[1]

^[1]Российская медицинская академия непрерывного профессионального образования (Москва)

Острый риносинусит – это распространенное воспаление носа и околоносовых пазух. Диагноз «синусит» основывается на сочетании клинических данных с осмотром, данными инструментальных исследований. На вирусные ОРС приходится свыше 90[%] случаев заболевания. Бактериальная этиология синусита имеет место примерно в 55–65[%] случаев. Целью лечения острого РС является ликвидация очага инфекции, восстановление пассажа в области остиомеатального комплекса, налаживание дренажной функции, уменьшение воспаления и облегчение симптомов, таких как боль и заложенность носа. Основными направлениями лечения являются антибактериальная терапия, ирригация, противовоспалительная терапия. Топические кортикостероиды – препараты первой линии, наряду с ирригацией. Они могут использоваться как в качестве монотерапии, так и в дополнение к антибактериальной терапии. При легких формах ОРС мометазон в дозе 400 мкг/сут оказался значительно более эффективным, чем плацебо и амоксициллин. А добавление топических кортикостероидов (МФ) к стандартному курсу системной антибиотикотерапии (амоксициллин/клавуланат, цефуроксим) значительно быстрее по сравнению с плацебо облегчало симптомы острого РС и ускоряло выздоровление. Интраназальные стероиды помогают в лечении дневного кашля. При сравнении с лечением другими ИГКС мометазон обладает большей эффективностью, безопасностью, лучшим разрешением симптомов, меньшей стоимостью лечения. Мометазон может использоваться беременными женщинами без опасения системных проявлений.

острый риносинусит

топические стероиды

мометазона фуроат

Амоксициллин

Безопасность

Беклометазон

Беременность

Биодоступность

Боли

Будезонид

Вирусы

Воспаление

Выздоровление

Женщины беременные

Карповые

Клетки

Легкие

Мометазона фуроат

Надпочечников коры гормоны

Нос

Носовые придаточные полости

Плацебо

Риносинусит

Флутиказон

Цефуроксим

Fokkens W.J., Lund V.J., Mullol J. et.al. European Position Paper on Rhinosinusitis and Nasal Polyps. Rhinology. 2012; 50: 23: 1–299.

D. Passali, M.C. Spinosi, A. Crisanti, L.M. Bellussi. Mometasone furoate nasal spray: a systematic review. Multidisciplinary Respiratory Medicine (2016) 11: 18 DOI 10.1186/s40248—016–0054—3.

Ashworth M, Charlton J, Ballard K, Latinovic R, Gulliford M. Variations in antibiotic prescribing and consultation rates for acute respiratory infection in UK general practices 1995–2000. Br J Gen Pract. 2005; 55(517): 603–608.

Dosh SA, Hickner JM, Mainous AG III, Ebell MH; Upper Peninsula Research Network. Predictors of antibiotic prescribing for nonspecifi c upper respiratory infections, acute bronchitis, and acute sinusitis. An UPRNet study. J Fam Pract. 2000; 49(5): 407–414.

Snow V, Mottur-Pilson C, Hickner JM. Principles of appropriate antibiotic use for acute sinusitis in adults. Annals of International Medicine 2001; 134(6): 495–7.

Little DR, Mann BL, Godbout CJ. How family physicians distinguish acute sinusitis from upper respiratory tract infections: a retrospective analysis. Journal of the American Board of Family Practice 2000; 13(2): 101–6.

Zalmanovici Trestioreanu A, Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database Syst Rev. 2013; 12: CD005149.

Anand VK. Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol 2004; 113(Suppl 193): 3–5.

Pleis JR, Coles R. Summary health statistics for U.S. adults: National Health Interview Survey, 1998. National Center for Health Statistics. Vital Health Stat 2002; 10: 1–113.

Kaliner MA, Osguthorpe JD, Fireman P, et al. Sinusitis: bench to bedside. Current findings, future directions. Otolaryngol Head Neck Surg 1997; 116(6 Pt 2): S1–S20.

Рязанцев С.В. Принципы этиопатогенетической терапии острых синуситов: Методические рекомендации. 2013. – 40 с.

Денисов И.Н. Острый риносинусит: клинические рекомендации. 2014. – 27с.

Eccles R. Mechanisms of the symptoms of rhinosinusitis. Rhinology. 2011 Jun; 49(2): 131–8.

Lin SW, Wang YH, Lee MY, Ku MS, Sun HL, Lu KH, et al. Clinical spectrum of acute rhinosinusitis among atopic andnonatopic children in Taiwan. Int J Pediatr Otorhinolaryngol. 2012 Jan; 76(1): 70–5.

Melvin TA, Lane AP, Nguyen MT, Lin SY. Allergic rhinitis patients with recurrent acute sinusitis have increased sinonasal epithelial cell TLR9 expression. Otolaryngology-head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery.2010 May; 142(5): 659–64.

Vlastos I, Athanasopoulos I, Mastronikolis NS, Panogeorgou T, Margaritis V, Naxakis S, et al. Impaired mucociliary clearance in allergic rhinitis patients is related to a predisposition to rhinosinusitis. Ear, nose, & throat journal. 2009 Apr; 88(4): E17–9.

Spector SL, Bernstein IL, Li JT, Berger WE, Kaliner MA, Schuller DE, et al. Parameters for the diagnosis and management of sinusitis. Journal of Allergy and Clinical Immunology 1998; 102(Suppl): 107–44.

Zuskin E, Mustajbegovic J, Schachter EN, Kern J, Deckovic-Vukres V, Pucarin-Cvetkovic J, et al. Respiratory findings in pharmaceutical workers. Am J Ind Med.2004 Nov; 46(5): 472–9.

Jaakkola MS, Jaakkola JJ. Office equipmentand supplies: a modern occupational health concern? Am J Epidemiol. 1999 Dec 1; 150(11): 1223-8.

Duclos P, Sanderson LM, Lipsett M. The1987 forest fire disaster in California: as ses sment of emergenc y room visits. Arch Environ Health. 1990 Jan-Feb; 45(1): 53–8

Winther B, Gwaltney JM Jr. Therapeutic approach to sinusitis: antiinfectious therapy as the baseline of management. Otolaryngology Head and Neck Surgery 1990; 103(5 (Pt 2)): 876–9.

Pitkaranta A, Arruda E, Malmberg H, et al. Detection of rhinovirus in sinus brushings of patients with acute community-acquired sinusitis by reverse transcription-PCR. J Clin Microbiol 1997; 35: 1791–3.

Pitkaranta A, Starck M, Savolainen S, et al. Rhinovirus RNA in the maxillary sinus epithelium of adult patients with acute sinusitis. Clin Infect Dis 2001; 33: 909-11.

MacNaughton MR. Occurrence and frequency of coronavirus infections in humans as determined by enzyme-linked immunosorbent assay. Infect Immun 1982; 38: 419–23.

Gwaltney Jr JM, Sydnor Jr A, Sande MA. Etiology and antimicrobial treatment of acute sinusitis. Ann Otol Rhinol Laryngol 1981; 90: 68–71.

Wald ER, Milmoe GJ, Bowen A. Acute maxillary sinusitis in children. N Engl J Med 1981; 304: 749–54.

Gwaltney Jr JM. The common cold. In: Mandell GL, Douglas Jr RG, Bennett JE, editors. Principles and practice of infectious diseases. 3rd ed. New York (NY): Churchill Livingstone; 1990. p. 489–93.

Heikkinen T, Jarvinen A. The common cold. Lancet. 2003 Jan 4; 361(9351): 51-9.

Demoly P. Safety of intranasal corticosteroids in acute rhinosinusitis. Am J Otolaryngol. 2008; 29(6): 403–413.

Tutkun A, Inanli S, Batman C, Uneri C, Sehitoglu MA. The impact of intranasal steroid as an adjunct to therapy for sinusitis. Marmara Medical Journal 1996; 9(1): 11–4

Shapiro GG, Rachelefski GS. Introduction and definition of sinusitis. Journal of Allergy and Clinical Immunology 1992; 90: 417–8

Penagos M, Compalati E, Tarantini F, BaenaCagnani CE, Passalacqua G, Canonica GW. Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials. Allergy. 2008; 63(10): 1280–91.

Baldwin CM, Scott LJ. Mometasone furoate: a review of its intranasal use in allergic rhinitis. Drugs. 2008; 68(12): 1723–39.

Blaiss MS. Evolving paradigm in the management of allergic rhinitis associated ocular symptoms: intranasal corticosteroids. Curr Med Res Opin. 2008; 24(3): 821–36.

Slavin RG. Sinusitis in adults and its relation to allergic rhinitis, asthma, and nasal polyps. J Allergy Clin Immunol 1988; 82: 950–6.

Slavin RG, Spector SL, Bernstein IL. The diagnosis and management of sinusitis: a practice parameter update. J Allergy Clin Immunol 2005; 116: S13–S47.

Morris P., Leach A. Antibiotics for persistent nasal discharge (rhinosinusitis) in children. Cochrane Database Syst Rev 2008; (3): CD001094

Kassel JC, King D, Spurling GK. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev. 2010; (3): CD006821

Hildenbrand T, Weber R, Heubach C, Mosges R. Nasal douching in acute rhinosinusitis (Article in German). Laryngorhinootologie. 2011; 90(6): 346–51

Chow A. W., Benninger M. S., Brook I. et al. IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clin Infect Dis. 2012; 54 (8): e72–e112

Лопатин А.С., Свистушкин В.М. Острый риносинусит: этиология, патогенез, диагностика и принципы лечения. Клинические рекомендации. М.: Российское общество ринологов, 2009. 26 с.

Low DE, Desrosiers M, McSherry J, et al. A practical guide for the diagnosis and treatment of acute sinusitis. CMAJ. 1997; 156(Suppl 6): S1– S14.

Candy B, Hotopf M. Steroids for symptom control in infectious mononucleosis. Cochrane Database Syst Rev. 2006; 3: CD004402.

Russell K, Wiebe N, Saenz A, et al. Glucocorticoids for croup. Cochrane Database Syst Rev. 2004; (1): CD001955.

Hayward G, Thompson M, Heneghan C, Perera R, Del Mar CB, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ. 2009; 339: b2976.

Mygind N, Nielsen LP, Hoffmann HJ, et al. Mode of action of intranasal corticosteroids. J Allergy Clin Immunol 2001; 108: S16–25.

Hutchison KA, Scherrer LC, Czar MJ, et al. Regulation of glucocorticoid receptor function through assembly of a receptor-heat shock protein complex. Ann NY Acad Sci 1993; 684: 35–48.

Wissink S, van de Stolpe A, Caldenhoven E, et al. NF-kappa B/Rel family members regulating the ICAM-1 promoter in monocytic THP-1 cells. Immunobiology 1997; 198: 50–64.

LeVan TD, Behr FD, Adkins KK, et al. Glucocorticoid receptor signaling in a bronchial epithelial cell line. Am J Physiol 1997; 272: L838–43.

Dolor RJ, Witsell DL, Hellkamp AS, et al, for the Ceftin and Flonase for Sinusitis (CAFFS) Investigators. Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis: The CAFFS trial: a randomized controlled trial. JAMA 2001; 286: 3097–105.

Huang A, Govindaraj S. Topical therapy in the management of chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2013; 21(1): 31 – 8.

G. Hayward, C. Heneghan, R. Perera, M. Thompson. Intranasal Corticosteroids in Management of Acute Sinusitis: A Systematic Review and Meta-Analysis. Ann Fam Med 2012; 10: 241–249. doi: 10.1370/afm.1338..
DOI: 10.1370/afm.1338

Kim KT, Rabinovitch N, Uryniak T, et al. Effect of budesonide aqueous nasal spray on hypothalamic-pituitary-adrenal axis function in children with allergic rhinitis. Ann Allergy Asthma Immunol 2004; 93: 61–7.

Bross-Soriano D, Hanenberg-Milver C, Schimelmitz-Idi J, et al. Effects of three nasal topical steroids in the intraocular pressure compartment. Otolaryngol Head Neck Surg 2004; 130: 187–91.

Opatowsky I, Feldman RM, Gross R. Intraocular pressure elevation associated with inhalation and nasal corticosteroids. Ophthalmology 1995; 102: 177–9.

Affrime MB, Kosoglou T, Thonoor CM, Flannery BE, Herron JM. Mometasone furoate has minimal effects on the hypothalamic-pituitaryadrenal axis when delivered at high doses. Chest. 2000; 118(6): 1538 – 46.

Skoner DP, Meltzer EO, Milgrom H, Stryszak P, Teper A, Staudinger H. Effects of inhaled mometasone furoate on growth velocity and adrenal function: a placebo-controlled trial in children 4-9 years old with mild persistent asthma. J Asthma. 2011; 48(8): 848 – 59.

Schenkel EJ, Skoner DP, Bronsky EA, Miller SD, Pearlman DS, Rooklin A. Absence of growth retardation in children with perennial allergic rhinitis after one year of treatment with mometasone furoate aqueous nasal spray. Pediatrics 2000; 105: E22

Johnson M. Pharmacodynamics and pharmacokinetics of inhaled glucocorticoids. J Allergy Clin Immunol 1996; 97: 169–76.

Nayak AS, Settipane GA, Pedinoff A, et al, and the Nasonex Sinusitis Group. Effective dose range of mometasone furoate nasal spray in the treatment of acute rhinosinusitis. Ann Allergy Asthma Immunol 2002; 89: 271–8.

The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med 2000; 343: 1054–63.

Samoliński B, Nowicka A, Wojas O, Lipiec A, Krzych-Fa ł ta E, Tomaszewska A. Intranasal glucocorticosteroids not only in allergic rhinitis In the 40th anniversary of intranasal glucocorticosteroids ’ introduction. Otolaryngol Pol. 2014; 68(2): 51–64.

Penagos M, Compalati E, Tarantini F, BaenaCagnani CE, Passalacqua G, Canonica GW. Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta-analysis of randomized, double-blind, placebo-controlled, clinical trials. Allergy. 2008; 63(10): 1280 – 91.

Baldwin CM, Scott LJ. Mometasone furoate: a review of its intranasal use in allergic rhinitis. Drugs. 2008; 68(12): 1723 – 39.

Blaiss MS. Evolving paradigm in the management of allergic rhinitis associated ocular symptoms: intranasal corticosteroids. Curr Med Res Opin. 2008; 24(3): 821 – 36.

Nielsen LP, Dahl R. Comparison of intranasal corticosteroids and antihistamines in allergic rhinitis: a review of randomized, controlled trials. Am J Respir Med. 2003; 2(1): 55 – 65.

Weiner JM, Abramson MJ, Puy RM. Intranasal corticosteroids versus oral H1-receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials. BMJ. 1998; 317(7173): 1624–9.

Fausnight TB, Craig TJ. Mometasone furoate dry powder inhaler for the treatment of asthma. Expert Opin Pharmacother. 2011; 12(17): 2707–12.

Milgrom H. Mometasone furoate in children with mild to moderate persistent asthma: a review of the evidence. Paediatr Drugs. 2010; 12(4): 213 – 21.

Mion OG, Mello JF Jr, Dutra DL, Andrade NA, Almeida WL, Anselmo-Lima WT et al. Position statement of the Brazilian Academy of Rhinology on the use of antihistamines, antileukotrienes, and oral corticosteroids in the treatment of inflammatory sinonasal diseases. Braz J Otorhinolaryngol. 2017 Mar – Apr; 83(2): 215–227.

Язык текста: Русский

ISSN: 2079-701X