哮喘联盟

   摘要
   目的：哮喘儿童的基础皮质醇水平降低的临床意义尚不清楚。试验对哮喘儿童与健康儿童的标准化运动测试后的唾液皮质醇反应进行了比较。
   方法：研究纳入19例青春期前哮喘儿童和20例青春期前健康儿童，完成标准化运动测试两次。检测运动前、运动后即刻和运动后15分钟的唾液皮质醇水平。通过检测在家中收集的唾液测定晨起唾液皮质醇水平。
   结果：20米往返运动测试后，健康儿童的唾液皮质醇水平增加84.2％，而哮喘儿童增加35%。健康儿童的唾液皮质醇水平平均增幅为200.3％[95％可信区间（CI），141.8-346.1]，哮喘儿童为89.8％（95％CI为56.9-181.6）。该反应与晨起唾液皮质醇水平或吸入维持剂量的糖皮质激素不相关。哮喘儿童往返运动测试的疲惫平均时间都显著缩短（平均差1.4分钟，95％CI，0.7-2.3）。没有儿童由于呼吸困难而终止试验。
   结论：研究表明，与健康儿童相比，使用吸入糖皮质激素（ICS）维持剂量的哮喘儿童的唾液皮质醇反应有所减弱。
 

（杨冬 审校）
JPediatrEndocrinolMetab.2014Sep11.pii:/j/jpem.ahead-of-print/jpem-2014-0061/jpem-2014-0061.xml. doi: 10.1515/jpem-2014-0061. [Epub ahead of print]

 

Attenuated salivary cortisol response after exercise test in children with asthma.
 

Hiemstra I, Heijsman SM, Koers NF, Bocca G, van der Veen BS, Veeger NJ, Kamps AW.
 

ABSTRACT
OBJECTIVE: The clinical relevance of lower basal cortisol levels in children with asthma is unclear. We compared the salivary cortisol response after a standardized exercise test in children with asthma versus the salivary cortisol response in healthy children.
METHODS: Nineteen prepubertal children with asthma and 20 prepubertal healthy children performed a standardized exercise test twice. Salivary cortisol levels were determined before exercise and immediately and 15 min after exercise. Morning salivary cortisol levels were determined from saliva collected at home.
RESULTS: Salivary cortisol levels increased in 84.2% of the healthy children compared to 35.0% in children with asthma after the 20-m shuttle-run test. Median increase in salivary cortisol levels was 200.3% [95% confidence interval (CI), 141.8-346.1] in healthy children compared to 89.8% (95% CI, 56.9-181.6) in children with asthma. The response was not related to the morning salivary cortisol level or maintenance dose of inhaled corticosteroids. The mean time to exhaustion of both shuttle-run tests was significantly shorter in children with asthma (mean difference 1.4 min; 95% CI, 0.7-2.3). None of the children had to stop because of dyspnea.
CONCLUSION: Our study demonstrates that children with asthma using a maintenance dose of inhaled corticosteroids (ICS) have an attenuated salivary cortisol response compared with healthy children.
 

JPediatrEndocrinolMetab.2014Sep11.pii:/j/jpem.ahead-of-print/jpem-2014-0061/jpem-2014-0061.xml. doi: 10.1515/jpem-2014-0061. [Epub ahead of print]