ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ

Year 2020, , 319 - 326, 14.10.2020

Sehra Birgül Batmaz

https://doi.org/10.18229/kocatepetip.573382

Abstract

AMAÇ: Astım çocukluk çağının en sık kronik hastalıklarından biridir. Çalışmamızın amacı polikliniğimizde astım tanısı ile iz-lenen hastalarımızın demografik, klinik, laboratuvar özelliklerini incelemek, verilen tedavileri, hastaların ilaç kullanım tekniği doğruluğu ve ilaç uyumunu değerlendirmektir. GEREÇ VE YÖNTEM: Polikliniğimizde astım tanısı alan 188 hastanın dosyalarından yaş, cinsiyet, ailesel atopi, pasif sigara maruziyeti verileri kaydedildi. Kan mutlak eozinofil sayısı, serum total IgE, alerjen spesifik IgE, cilt delme testi, besin yükleme testi sonuçları incelendi. Hastalar Global Initiative for Asthma (GINA 2018) ve Allergic Rhinitis and its Impact on Asthma (ARIA 2016) kılavuzlarına göre hastalık kontrol/ağırlık gruplarına ayrıldı. Astım kontrol testi, çocukluk çağı astım kontrol testi ve çocuklar için solunum ve astım kontrol testi sonuçları kaydedildi. Hastaların başvuruda almakta olduğu ve tarafımızca başlanan tedaviler incelendi. Başvuru ve ilk kontrol muayenelerinde inhaler tekniklerin doğru uygulanması ve ilaç uyumu değerlendirildi. Bu değerlendirmeler için tanımlayıcı istatistiksel analizler kullanıldı. BULGULAR: Hastaların yaş ortalaması 8,41±3,52 yaş (1,5-16,5) ve 107 (%56,9) hasta erkek idi. 52 hastada ailesel atopi, 60 has-tada sigara maruziyeti vardı. Hastalar astım açısından en çok iyi kontrollü, alerjik rinit açısından en çok orta-ağır grupların-daydı. 82 hastada solunumsal alerjen duyarlılığı, iki hastada da besin alerjisi saptanmıştı. Hastaların %39,89’una dış merkezde, %31,91’ine tarafımızca kontrol edici tedavi başlanmıştı. İlaç uyu-mu bilgisine ulaşılabilen hastaların %33,59’unun ilaç uyumsuz hasta olduğu görüldü. Hastaların %39,28’inin başvuruda, en az bir kez kontrole gelenlerin %24,48’inin kontrol muayenesinde inhaler tekniği doğru uygulamadığı görüldü.SONUÇ: Çalışmamızda ilimizdeki astımlı çocuk hastaların demografik, klinik, laboratuvar bulguları, tedavileri ve tedavi uyumları değerlendirilmiştir. Ailede astım varlığı ve alerjik rinit eşlik etme sıklıkları literatürle uyumludur. Tedavide ağırlık/kont-rol düzeyinin dikkate alınması tekrar hatırlanmalıdır. İlaç uyumsuzluğu ve yanlış teknikle kullanım hastalarımızda da yüksek oranda olup tedavi başarısı için akılda tutulmalıdır. Ülkemizdeki astımlı çocukların değerlendirildiği literatürdeki az sayıdaki çalışmaya katkıda bulunulmuştur.

Keywords

allerji, astım, çocuk

EVALUATION OF DEMOGRAPHIC, CLINICAL AND LABORATORY CHARACTERISTICS OF PEDIATRIC PATIENTS WITH ASTHMA

Abstract

OBJECTIVE: Asthma is one of the most prevalent chronic diseases of childhood. The aim of the study was to evaluate the demographic, clinical and laboratory characteristics of our patients who are followed up with diagnosis of asthma in our clinic, and to evaluate the treatments given, the correctness of the patients' drug use technique and drug compliance.
MATERIAL AND METHODS: Data of age, sex, familial atopy, passive smoking exposure of 188 asthma patients were recorded from their patient files. Absolute eosinophil count, serum total IgE and allergen-specific IgE levels, skin prick test and oral food provocation test results at presentation were investigated. The patients were grouped according to disease control/severity based on the Global Initiative for Asthma (GINA 2018) and Allergic Rhinitis and its Impact on Asthma (ARIA 2016) guidelines. The patients’ asthma control test, childhood asthma control test and test for respiratory and asthma control in kids’ scores were recorded. The previously prescribed treatment at presentation or newly started treatments were investigated. The patients were evaluated for their correct inhaler utilization techniques at presentation and the first follow-up visit. Descriptive statistics were used for these evaluations.
RESULTS: The mean age of the patients was 8,41±3,52 (1,5-16,5) years, and 107 (56,9%) of them were boys. Familial atopy was present in 52, and smoking exposure in 60 patients. Most of the patients were well-controlled for asthma, and moderate-to-severe severity for allergic rhinitis. 82 of the patients had aeroallergen sensitivity, and two were diagnosed with food allergy. The controller medication was started by an external healthcare center in 39,89% of the patients and by us in 31,91% of the patients. Results demonstrated that 33,59% of the patients whose medication adherence information could be obtained were non-adherent. It was observed that 39,28% of the patients and 24,48% of the patients who came for control at least once did not utilize a correct inhaler technique during the control examination.
CONCLUSIONS: In the current study, the demographic, clinical and laboratory results, prescribed treatments and treatment adherence of the pediatric patients with asthma residing in our city were evaluated. Presence of asthma in the family and frequency of accompanying allergic rhinitis are consistent with the literature. It should be remembered to consider the weight/control level in the treatment. Drug incompatibility and using it with wrong technique is also high in our patients and this situation should be kept in mind for the success of the treatment. These results will contribute to the few studies in the literature evaluating children with asthma.

Keywords

Allergy, Asthma,, Pediatrics

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