沙美特罗和丙酸氟替卡松联合治疗以及丙酸氟替卡松单独治疗对轻症哮喘患者气道功能和嗜酸性粒细胞性炎症反应
2009/07/10
背景：沙美特罗和丙酸氟替卡松联合治疗（SFC）较丙酸氟替卡松单独治疗对哮喘的控制更佳。但两种治疗方法对轻度哮喘患者气道功能和炎症的影响知之甚少。
方法：随机选取27名轻度持续性哮喘患者，这些患者入组前均接受了相当于400mug剂量的丙酸倍氯米松治疗，入组时分别给予每天2次且持续8周的SFC（50/100mug, 13 名患者）或FP (100mug, 14名患者)治疗。比较SFC和FP对患者肺功能（采用肺量测定和脉冲震荡法检测[IOS]）、痰液和血清嗜酸性粒细胞百分比及对哮喘症状及其控制情况的影响。
结果：与FP 相比，SFC治疗能显著改善1 s用力呼气量（P < 0.05）、IOS检测的总阻力R5（P < 0.01）、中央阻力R20（P < 0.05）和远端阻力X5（P < 0.01）。痰液（而不是血清）嗜酸性粒细胞百分比下降在SFC组更明显（P < 0.05），且SFC组哮喘症状控制更佳（P < 0.05）。
结论：上述结果显示，轻度持续的哮喘患者中，SFC治疗优于FP。SFC的临床优势也为IOS和痰液检测气道功能和炎症提供了依据。
（苏楠 审校）
Hoshino M, et al. Allergol Int. 2009 May 25;58(3). [Epub ahead of print]
Effects of Salmeterol and Fluticasone Propionate Combination versus Fluticasone Propionate on Airway Function and Eosinophilic Inflammation in Mild Asthma.
Hoshino M, Handa H, Miyazawa T.
Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Background: Salmeterol and fluticasone propionate combination (SFC) provides better asthma control than fluticasone propionate (FP) alone, however, little is known on the effects of differential treatments on airway function and inflammation in patients with mild asthma.
Division of Respiratory and Infectious Diseases, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Background: Salmeterol and fluticasone propionate combination (SFC) provides better asthma control than fluticasone propionate (FP) alone, however, little is known on the effects of differential treatments on airway function and inflammation in patients with mild asthma.
Methods: We randomized 27 mild persistent asthma patients treated with the equivalent of 400mug beclomethasone dipropionate to receive SFC (50/100mug, 13 patients) or FP (100mug, 14 patients) twice daily for 8 weeks. We compared the effects of SFC and FP on pulmonary function assessed by spirometry and impulse oscillometry (IOS), eosinophil percentage of induced sputum and serum, and with asthma symptoms and control after each treatment.
Results: We observed that SFC significantly improved forced expiratory volume in one second (p < 0.05), IOS measurements of total resistance R5 (p < 0.01), central resistance R20 (p < 0.05), and distal reactance X5 (p < 0.01) compared with FP. The percentage of eosinophils in sputum, but not in serum, decreased significantly more in the SFC group than in the FP group (p < 0.05). There was also a significant improvement in symptom control in the SFC group (p < 0.05).
Conclusions: These findings suggest that SFC is more useful than FP in mild asthma cases. The clinical benefit of SFC provides evidence that IOS and induced sputum allows for the detection of changes in airway function and inflammation.
上一篇：
学龄期哮喘儿童的过敏性鼻炎：诊断和治疗欠佳？一项在儿童医院进行的回顾性研究
下一篇：
使用福莫特罗和吸入糖皮质激素对慢性哮喘进行常规治疗：严重副作用
