哮喘联盟

   摘要
   背景：由于类固醇激素存在多种副作用，应尽量减少它们在支气管哮喘发作治疗中的使用。我们对吸入用布地奈德混悬液（BIS）是否可以替代静脉注射类固醇激素治疗中度支气管哮喘发作进行了研究。
   受试者和方法：受试者为入院进行中度支气管哮喘发作治疗的5岁及以下儿童。患者随机分为两组：20例患者接受甲强龙(mPSL)治疗，另外20例患者接受BIS治疗。mPSL组治疗方案：盐酸丙卡特罗(0.3 mL)和色甘酸二钠(2 mL)吸入，一天三次；mPSL静脉注射(1 mg/kg)，一天三次。BIS组治疗方案：盐酸丙卡特罗(0.3 mL)和BIS(0.5 mg)吸入，一天三次。根据症状的严重程度，对吸入频率和类固醇激素的注射频率进行相应调整。测定出院时的皮质醇水平。
   结果：两组患者在发作严重程度和控制时间、疗效、喘息持续时间和住院时间方面无显著差异。在住院的第3-6天，BIS组的吸入频率较mPSL组低；且出院时BIS组的皮质醇水平(13.9 ± 6.1 μg/dL)明显高于mPSL组(8.0 ± 2.1 μg/dL) (p = 0.008)。
   结论：在反复喘息或支气管哮喘<5年的患者，BIS治疗中度支气管哮喘发作的效果与mPSL相当或更好；且与类固醇激素不同，BIS治疗不抑制肾上腺皮质的功能。
 

（杨冬 审校）
World Allergy Organ J. 2015 May 5;8(1):14. doi: 10.1186/s40413-015-0065-0. eCollection 2015.

 

Budesonide inhalation suspension versus methylprednisolone for treatment of moderate bronchial asthma attacks.
 

Yanagida N1, Tomikawa M1, Shukuya A1, Iguchi M1, Ebisawa M2.
 

Abstract
BACKGROUND:Owing to their side effects, administration of steroids for bronchial asthma attacks should be minimized. We investigated whether budesonide inhalation suspension (BIS) could replace intravenous steroid administration for the treatment of moderate bronchial asthma attacks.
SUBJECTS AND METHODS:The subjects were children aged 5 years and younger hospitalized for moderate bronchial asthma attacks. Patients were randomly assigned to one of two groups: 20 patients received methylprednisolone (mPSL) and 20 were treated with BIS. The mPSL group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and disodium cromoglycate (2 mL) three times a day and systemic administration of mPSL (1 mg/kg) three times a day. The BIS group began treatment with inhalation of procaterol hydrochloride (0.3 mL) and BIS (0.5 mg) three times a day. The frequency of inhalations and steroid administration was adjusted according to the severity of symptoms. The cortisol level at discharge was measured.
RESULTS:There were no significant differences between the two groups in terms of the severity of attacks and duration of management, or in terms of therapeutic efficacy, duration of wheezing, or period of hospitalization. The frequency of inhalations on days 3 to 6 of hospitalization was lower in the BIS group than in the mPSL group, and the cortisol level at discharge was significantly higher in the BIS group (13.9 ± 6.1 μg/dL) than in the mPSL group (8.0 ± 2.1 μg/dL) (p = 0.008).
CONCLUSION:In patients with recurrent wheezing or bronchial asthma of <5 years, the efficacy of BIS is equivalent or better than mPSL for moderate bronchial asthma attacks, and in contrast to steroid treatment, BIS treatment do not suppress adrenocortical function.
 

World Allergy Organ J. 2015 May 5;8(1):14. doi: 10.1186/s40413-015-0065-0. eCollection 2015.