吸入沙美特罗/氟替卡松治疗儿童支气管哮喘临床疗效与骨密度观察  

Study the clinical curative effect and safety of inhaled salmeterol/fluticasone in curing childhood bronchial asthma

作　　者：冯益真[1] 李颖[1] 李瑞峰[2] 董琰 潘恒明[1] 

机构地区：[1]山东大学附属省立医院呼吸儿科,济南250021 [2]济宁市第一人民医院儿科,272100 [3]青岛警备区第四干休所,266000

出　　处：《中华哮喘杂志（电子版）》2009年第4期32-34,共3页Chinese Journal of Asthma(Electronic Version)

摘　　要：目的观察支气管哮喘(简称哮喘)儿童吸入沙美特罗/氟替卡松(商品名舒利迭)治疗儿童哮喘的临床疗效与骨密度变化。方法随机、自身对照法观察500例[男288例,女212例,平均年龄(9.5±4.8)岁],轻、中、重度各62例、278例和98例]哮喘儿童吸入沙美特罗/氟替卡松(50/100μg),每次一吸,轻、中度2次/d,重度2次/d+辅舒酮125μg,按需用短效β2受体激动剂。每2～8周评估1次病情控制情况,240例患儿由专人观察记录患儿自身治疗前后的早、晚PEF%(实测值/预计值),日、夜间症状评分,β2受体激动剂应用揿数,医师综合疗效评价,急诊、住院次数及骨密度和其他不良反应。结果肺功能、日、夜间症状评分,医师对疗效的评价均随治疗时间的延长有显著好转或改善,而β2受体激动剂用量和急诊、住院次数则显著减少,骨密度原降低者均恢复正常或显著改善,原正常者均正常。偶有声哑等轻微局部不良反应。结论沙美特罗/氟替卡松能显著改善哮喘儿童肺功能,控制哮喘日、夜间症状,减少β2受体激动剂用量和急诊或住院次数,提高患儿生活质量,无明显不良反应,是当前理想的哮喘治疗药物。Objective To observe the curative effect and safety of inhaled salmeterol/fluticasone in asthmatic children. Methods Through open, random and parallel the control group to observe 500 [288 male, 212 female, mean age （9.5 ± 4.8） years, 60,278,98, cases of light, moderate and severe respectively] asthmatic children. Inhale salmeterol/fluticasone （50/100 μg） one inhalation a time, light and moderate patients twice-daily, severe twice-daily plus flixotide 125 μg, apply β adrenoceptor agonist when need. Evaluate patient＇s condition per 2-8 weeks, refer to stepped treatment plan. Morning and evening percentage of peak expiratory flow （actual date estimated date ） of prior and after treatment,symptom score of day and night,the dosis of β2 adrenoeeptor agonist, and doctors comprehensive evaluation of curative effect, times of emergency treatment and in hospital, bone density and other adverse reactions were recorded by special messenger. Results Follow the prolonged time of therapy, pulmonary function, symptom score of day and night, doctors evaluation of curative effect all improved significantly, the dosis of β2 adrenoceptor agonist, times of emergency treatment and in hospital decreased evidently, former bone density degraded regain normal or improved significantly,previous normal still to remain normal. Light and local side effects such as celostomia occur by chance. Conclusions Salmeterol/fluticasone can improve asthmatic children＇s pulmonary function significantly, control asthmatic symptoms of day and night, reduce the dosis of β2 adrenoceptor agonist and the ratio of emergency treatment and in hospital times,increase the patient＇s quality of life, haven＇t apparente side effects,is an ideal medicine to cure asthma currently.

关 键 词：儿童哮喘 沙美特罗/氟替卡松 疗效 骨密度 

分 类 号：R725.622.5[医药卫生—儿科] R681.02[医药卫生—临床医学]