哮喘联盟

   摘要
   目的：比较雾化吸入布地奈德与口服泼尼松龙治疗儿童急性严重哮喘的疗效。
   方法：纳入5～12岁的支气管哮喘急性加重期儿童。研究（布地奈德）组每隔20分钟接受雾化吸入布地奈德治疗(800 μg)，只接受一剂安慰剂药片。对照（泼尼松龙）组每隔20分钟接受安慰剂治疗，只接受一剂口服泼尼松龙(2 mg/kg)。两组患者都接受三次雾化吸入柳丁氨醇治疗(0.15 mg/kg)。记录患者的心率、呼吸频率、氧饱和度、呼气峰值流速（PEFR）和健康出院情况。
   结果：两组治疗后心动过速情况都有所缓解，但研究组更显著(p = 0.0002)。两组均表现为呼吸急促显著减少、氧饱和度升高，但两组比较无显著差异(P = 0.334 和p = 0.814)。布地奈德组PEFR值显著改善(P = 0.024)。在最后2h的临床严重程度评分方面，两组都有显著改善(p < 0.0001)。2h后布地奈德组患者出院比例显著提高（基于临床严重程度评分）(P = 0.0278)。
   结论：与口服泼尼松龙比较，雾化吸入布地奈德能显著改善5-12岁急性严重哮喘儿童的PEFR水平和2h后出院率。
 

（刘国梁 审校）
J Pedi Indian atr. 2014 Jun 7. [Epub ahead of print]

 

Efficacy of Nebulised Budesonide versus Oral Prednisolone in Acute Severe Asthma.
 

Arulparithi CS1, Babu TA, Ravichandran C, Santhanam I, Sathyamurthi B, Parivathini S, Hemachitra J.
 

ABSTRACT
OBJECTIVE:To compare the efficacy of nebulised budesonide with that of oral prednisone in the treatment of acute severe asthma in children.
METHODS:Children aged 5-12 y with acute exacerbation of bronchial asthma were included. The study (budesonide) group received budesonide respirator solution (800 μg) at intervals of 20 min and a single dose of placebo tablets. The control (prednisolone) group received placebo solution at intervals of 20 min and a single dose of oral prednisolone (2 mg/kg). Both groups received three doses of nebulised salbutamol (0.15 mg/kg). Heart rate, respiratory rate, oxygen saturation, PEFR (Peak Expiratory Flow Rate) and fitness for discharge were assessed.
RESULTS: Both groups showed a progressive decrease in tachycardia with treatment, but it was significantly greater in study group (p = 0.0002). There was significant decrease in tachypnea and improvement in oxygen saturation in both groups, but the difference between the groups (p = 0.334 and p = 0.814 respectively) was not significant. There was significant improvement in PEFR values in budesonide group (p = 0.024). Both groups showed significant improvement in clinical severity scores at the end of 2 h (p < 0.0001). Budesonide group had significantly higher proportion of patients fit for discharge at 2 h (based on clinical severity scores) (p = 0.0278).
CONCLUSIONS: Nebulised budesonide significantly improves PEFR levels and fitness for discharge at 2 h when compared to oral prednisolone in children between 5 and 12 y with acute severe asthma.
 

J Pedi Indian atr. 2014 Jun 7. [Epub ahead of print]