urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.3.34DPULHDurmj-1903Research ArticleОригинальные статьи | Original articlesOriginal articlesПассивная иммунопрофилактика респираторно-синцитиальной вирусной инфекции у недоношенных детей групп риска: роль в снижении респираторной заболеваемости в периоде раннего возрастаPassive Immunoprophylaxis of Respiratory Syncytial Virus Infection in Premature Infants at Risk: A Role in Reducing Respiratory Morbidity in Early Childhoodhttps://orcid.org/0000-0003-4053-4405ИбрагимоваЮ. Н.IbragimovaIu. N.

Ибрагимова Юлия Николаевна — ассистент кафедры госпитальной педиатрии, институт педиатрии и репродуктивной медицины, УГМУ; педиатр детского консультативно-диагностического центра, Областная детская клиническая больница.

Екатеринбург

Iuliia N. Ibragimova — Assistant of the Department of Hospital Pediatrics, Institute of Pediatrics and Reproductive Medicine, Ural State Medical University; Pediatrician of the Children’s Consultative and Diagnostic Center, Regional Children’s Clinical Hospital.

Ekaterinburg

julia080685@gmail.comhttps://orcid.org/0000-0002-5274-4699ВахловаИ. В.VakhlovaI. V.

Вахлова Ирина Вениаминовна — доктор медицинских наук, профессор, заведующий кафедрой госпитальной педиатрии, директор института педиатрии и репродуктивной медицины, УГМУ; начальник отдела научной деятельности, Областная детская клиническая больница.

Екатеринбург

Irina V. Vakhlova — Doctor of Sciences (Medicine), Associate Professor of the Department of Hospital Pediatrics, Director of the Institute of Pediatrics and Reproductive Medicine, Ural State Medical University; Head of Scientific Department, Regional Children’s Clinical Hospital.

Ekaterinburg

pediatria@usma.ruУральский государственный медицинский университет; Областная детская клиническая больницаРоссияUral State Medical University; Regional Children’s Clinical HospitalRussian Federation20250607202524334–45Copyright © Ибрагимова Ю.Н., Вахлова И.В., 20252025Ибрагимова Ю.Н., Вахлова И.В.Ibragimova I.N., Vakhlova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1903Обоснование

Обоснование. Становление функции дыхания и увеличение доли выживаемости у детей с экстремально низкой и очень низкой массой тела, родившихся с респираторными нарушениями и морфофункциональной незрелостью органов дыхания, могут приводить к частому развитию бронхолегочной патологии в периоде раннего возраста. Эта когорта детей чаще относится к группе риска тяжелого респираторно-синцитиального вирусного (РСВ) бронхиолита, требующего госпитализации и проведения интенсивной терапии. Эффективной мерой в оказании помощи детям грудного возраста, входящих в группу риска, признается иммунопрофилактика с помощью моноклональных антител.

Цель исследования — провести оценку клинической эффективности иммунопрофилактики РСВ-инфекции в снижении респираторных заболеваний у недоношенных детей 1–3 лет.

Материалы и методы

Материалы и методы. Проведен ретро- и проспективный сравнительный анализ респираторной заболеваемости у недоношенных детей (гестационный возраст — 240–336 недель) в периоде раннего возраста в зависимости от проведения иммунопрофилактики РСВ на 1-м году жизни. В исследование включено 322 ребенка 1–3 лет: 225 детей, прошедших иммунизацию против РСВ-инфекции; 97 — не получивших иммунизацию.

Результаты

Результаты. Доказано, что иммунопрофилактика против РСВ у детей групп риска на 1-м году жизни уменьшает частоту острых респираторных заболеваний (ОРЗ), снижает риск эпизодов бронхиальной обструкции (БО) и пневмонии в возрасте 1–3 года. Продемонстрировано, что отсутствие иммунопрофилактики на 1-м году вносит статистически значимый вклад в развитие эпизодов БО (АП = 81 %) и пневмонии (АП = 58 %) в раннем возрасте. Выявлена обратная связь между частотой ОРЗ у детей раннего возраста и количеством полученных инъекций моноклональных антител (паливизумаба).

Заключение

Заключение. Применение инъекций моноклональных антител у детей групп риска развития РСВ-бронхиолитов позволило снизить частоту ОРЗ, эпизодов БО и пневмонии в раннем возрасте.

Rationale

Rationale. The development of respiratory function and an increase in the survival rate in children with extremely low and very low body weight with respiratory disorders and morphofunctional immaturity of the respiratory organs determines the frequent development of bronchopulmonary pathology in early childhood. These children are more often at risk for severe respiratory syncytial virus (RSV) bronchiolitis, are hospitalized and undergo intensive therapy. Immunoprophylaxis with monoclonal antibodies is recognized as an effective measure in providing assistance to these children.

Purpose of the study — evaluation of the clinical effectiveness of RSV immunoprophylaxis in reducing respiratory diseases in children aged 1–3 years.

Materials and methods

Materials and methods. A retro- and prospective analysis of morbidity in premature infants (gestational age — 240–336 weeks) in the early childhood period was conducted depending on immunization in the 1st year of life. The study included 322 children: 225 children received immunization, 97 did not.

Results

Results. It has been proven that immunoprophylaxis in children at risk in the 1st year reduces the incidence of acute respiratory infections (ARI), the risk of episodes of bronchial obstruction (ВО) and pneumonia at the age of 1–3 years. It has been demonstrated that the absence of immunoprophylaxis in the first year makes a significant contribution to the development of episodes of BO (AР = 81 %), pneumonia (AР = 58 %) at an early age. An inverse relationship has been shown between the frequency of ARI and the number of injections of monoclonal antibodies.

Conclusion

Conclusion. The use of monoclonal antibodies in children at risk reduces the incidence of ARI, episodes of BO and pneumonia in early childhood.

респираторно-синцитиальный вируснедоношенные детииммунопрофилактикадетиреспираторная заболеваемостьпаливизумабРСВ-инфекцияrespiratory syncytial viruspremature infantsimmunoprophylaxischildrenrespiratory morbiditypalivizumabRSV infectionАвторы выражают признательность руководству Областной детской клинической больницы (Екатеринбург) и лично главному врачу О.Ю. Аверьянову за оказанную помощь при проведении исследования, а также особую благодарность Л.Е. Сафроновой, Е.В. Власовой, И.А. Пашниной, А.Н. Морозову, М.Р. Мелиховой за профессиональную помощь на всех этапах исследования.The authors express their gratitude to the administration of the Regional Children’s Clinical Hospital (Ekaterinburg, Russia) and personally to the chief physician O.Yu. Averyanov for their assistance in conducting this study, and special thanks to L.E. Safronova, E.V. Vlasova, I.A. Pashnina, A.N. Morozov, M.R. 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The authors declare that there are no conflicts of interest present.