糖皮质激素吸入治疗可减少哮喘患儿的住院率
2009/10/15
背景：积极有效地应用吸入性糖皮质激素治疗可减少2岁以上哮喘患儿的哮喘急性发作次数和住院率。本研究目的是评估两个幼儿群体中哮喘患儿住院次数与年龄特异性哮喘维持治疗之间的相关性。
方法：收集芬兰2个省1995～1999年24个月以下儿童中哮喘治疗的相关数据，包括哮喘维持治疗（基于处方药）、每年住院次数和再住院率。患者入选标准为经3个或3个以上医生诊断的喘息发作，每个病例均经研究者进行逐一筛选。库皮欧地区平均共纳入5490例儿童，奥卢地区为9914例。
结果：研究期间，库皮欧地区<24个月的儿童中哮喘维持治疗者约占16.5/1000，其中90%使用了吸入糖皮质激素。奥卢地区，哮喘维持治疗和使用吸入性糖皮质激素的儿童分别占13.5/1000 (P<0.001)和99%。库皮欧地区和奥卢地区的平均入院率分别为7.9/1000和8.7/1000(P<0.05)。奥卢地区再入院率（占该地区总住院率的40%）高于库皮欧地区（占该地区总住院率的28%）(P<0.01)。
结论：积极有效地应用吸入性糖皮质激素治疗与减少<24个月的哮喘患儿的住院治疗次数相关，主要是减少了其再入院率。
（刘国梁 审校）
Korhonen K, et al.
World J Pediatr. 2009 Aug;5(3):177-181. Epub 2009 Aug 20.
Use of inhaled corticosteroids decreases hospital admissions for asthma in young children.
Korhonen K, Dunder T, Klaukka T, Reijonen TM, Korppi M.
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
BACKGROUND: An active use of inhaled corticosteroids for asthma has been associated with less asthma exacerbations and hospital admissions in children aged more than 2 years. The present study aimed to investigate hospital admission rates in young children from two populations in relation to the age-specific use of maintenance medication for asthma.
METHODS: Annual data on children aged less than 24 months treated for asthma, including data on the use of maintenance medication based on the purchases of prescribed medications, and annual numbers of admissions to hospital and proportions of readmissions, were collected from 1995 to 1999 in two provinces of Finland. The inclusion criteria, three or more doctor-diagnosed wheezing episodes, were individually checked by the authors in each case. The mean number of children aged less than 24 months during the years of the study was 5490 in Kuopio and 9914 in Oulu area.
RESULTS: In the Kuopio area, during the years of the study, 16.5/1000 children aged less than 24 months were on maintenance medication for asthma, and 90% of them were receiving inhaled corticosteroids. In the Oulu area, the respective figures were 13.5/1000 (P<0.001) and 99%. The average admission rate was 7.9/1000 in the Kuopio area and 8.7/1000 in the Oulu area (P<0.05). The readmissions indicated the higher admission rates in the Oulu (40% of all admissions) than in the Kuopio (28%) area (P<0.01).
CONCLUSION: Active use of maintenance therapy by inhaled corticosteroids was associated with a decreased need of hospital treatment in young children <24 months old with asthma, mainly because of less readmissions.
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糖皮质激素难治性哮喘新疗法的治疗靶点
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吸入性糖皮质激素加用妥洛特罗贴剂（β2受体激动剂）对哮喘的治疗效果
