Współczesne postępowanie w alergicznym nieżycie nosa.

• Authors: Panaszek Bernard

Title variants

EN

Current management of allergic rhinitis.

• Languages of publication: PL

Abstracts

PL

Wśród wzrastającej liczby chorób alergicznych, alergiczny nieżyt nosa (ANN) zajmuje czołową pozycję. Według badań epidemiologicznych przeprowadzonych w Polsce w ramach projektu ECAP (Epidemiologia Chorób Alergicznych w Polsce), schorzenie to dotyczy blisko 25% populacji, występując częściej u dzieci i w rejonach miejskich. ANN współistnieje w 80% przypadków z astmą oskrzelową i z alergicznym zapaleniem spojówek (AZS) – w 75% przypadków. ANN nieleczony stanowi duży, nawet ośmiokrotny wzrost ryzyka rozwoju astmy, ponadto powoduje częste zaostrzenia choroby i innych schorzeń towarzyszących, m.in. zapalenia zatok. Optymalne leczenie ANN zależy od fenotypu klinicznego (okresowy, przewlekły), wieku pacjenta oraz stopnia ciężkości choroby (lekki, umiarkowany, ciężki) i współistnienia AZS albo astmy. Zgodnie z wytycznymi raportu ARIA (Allergic Rhinitis and its Impact on Astma), podstawowe znaczenie w terapii ANN mają leki przeciwhistaminowe drugiej generacji (LPII), do których dodaje się miejscowe glikokortykosteroidy (mGKS) w przypadku ciężkiego przebiegu choroby. Obydwie grupy leków poprawiają również jakość życia (QoL) ocenianą za pomocą kwestionariuszy ogólnych i dostosowanych do specyfiki choroby. Obowiązuje również zasada zmniejszenia kontaktu z alergenem, ale skuteczność takiego postępowania wykazuje niewielkie znaczenie kliniczne. W uzasadnionych przypadkach skuteczna jest swoista immunoterapia alergenowa (SIT).

EN

Among rising number of allergy cases allergic rhinitis (AR) occupies highest level. According to epidemiological studies in Poland developed as ECAP project, AR occurs in 25% of population and is found more often in children and rural regions. The value of optimal therapy of AR arises not only from mentioned above epidemiological reasons, but also from relationships between AR and asthma where 80% coincidence is observed as well as allergic conjunctivitis (AC) with 75% comorbidity. AR not treated determines eight times higher risk of asthma developing, in addition causes both often asthma exacerbation and other comorbidities, among the others – sinusitis. Optimal treatment of AR depends on clinical phenotype of disease (intermittent, persistent) and the level of severity (mild, moderate, severe) as well as coincidence with AC and asthma. In concordance with ARIA (Allergic Rhinitis and its Impact on Asthma) rapport, mainstay therapy of AR are second generation antihistamines with addition of local glicocorticosteroids in cases of severe course of disease. Both antihistamines and local corticosteroids improves quality of life (QoL), evaluated by generic and specific questionnaires. The rule of allergen avoidance should be taken into consideration, but a value of this procedure is clinically slight. Specific immunotherapy (SIT) is effective in justified cases.

Keywords

PL

alergiczny nieżyt nosa; leki przeciwhistaminowe; glikokortykosteroidy; swoista immunoterapia alergenowa

EN

allergic rhinitis; antihistamines glucocorticosteroids; specific immunotherapy

• Publisher: Wydawnictwo Continuo
• Journal: Współczesne Pielęgniarstwo i Ochrona Zdrowia
• Year: 2014
• Issue: 1
• Pages: 19-23

Contributors

author

Panaszek Bernard

• Katedra i Klinika Chorób Wewnętrznych, Geriatrii i Alergologii, Uniwersytet Medyczny we Wrocławiu

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Identifiers

ISSN

2084-4212