小剂量阿奇霉素对哮喘儿童气道反应性的影响  

The influence to airway responsiveness of asthmatic children treated with low dose azithromycin

作　　者：王峥[1] 刘长山[1] 杨静[1] 李霞[1] 

机构地区：[1]天津医科大学第二医院儿科,300211

出　　处：《国际儿科学杂志》2012年第3期311-315,共5页International Journal of Pediatrics

摘　　要：目的探讨小剂量阿奇霉素对哮喘儿童气道反应性的影响。方法中重度持续哮喘患儿104例分为A组（56例）和B组（48例）。所有患儿均应用沙美特罗替卡松（50／100μg／剂）2剂／d，吸入4周，重度持续哮喘患儿加服孟鲁司特5mg／d，合并过敏性鼻炎者加糠酸莫米松100—200μg／d喷鼻，然后进入观察期。A组继续吸入沙美特罗替卡松（剂量同前），并加口服阿奇霉素7．5mg/kg·d）（最大剂量250mg／d），每周服药2d；B组仅继续吸人沙美特罗替卡松（剂量同前）。观察期为12周。试验结束两组分别评定观察期内有症状天数；开始及结束时，两组分别检测一秒钟用力呼气量（FEV1）、最大呼气峰流量（PEF）占预计值的百分率，观察期第15天及结束时检测使FEV。下降20％的组胺激发剂量（PD20-FEV1）；观察开始前24h及结束后24h分别检测24h尿17-羟皮质醇（17-OHCS）和17-酮皮质醇（17-KS）；试验结束后2周检测血清丙氨酸氨基转移酶（ALT）和天门冬氨酸氨基转移酶（AST）。结果（1）A、B两组有症状天数分别为（2．13±1．18）d、（2．25±1．19）d，差异无统计学意义（t=0．54，P=0．59）。（2）观察前、后PEF占预计值百分率：A组分别为（49．77±15．02）％、（82．73±7．81）％，差异有统计学意义（t=16．59，P=0．000），B组分别为（52．69±13．90）％、（81．15±7．28）％，差异有统计学意义（t=12．37，P=0．000）；观察前、后FEV1占预计值百分率：A组分别为（50．48±15．08）％、（83．18±6．61）％，差异有统计学意义（t=16．25，P=0．000），B组分别为（53．29±13．89）％、（82．73±6．10）％，差异有统计学意义（t=12．83，P=0．000）。（3）观察期第15天、结束时PD20-FEVI水平：A组分别为（65．13±26．08）μg、（460．79±221．72）μg，差异有统计学意义（t=13．54，P=0．000），B组分别为（65�Objective To investigate the influence to airway responsiveness by using low dose azithromycin in asthmatic children. Methods One hundred and four children with moderate persistent or severe persistent asthma were divided into Group A （ include 56 cases） and Group B （ include 48 cases） ran- domly. All of the patients were treated with seretide （50/100 ~Lg/dose） 2 doses/d for 4 weeks. Children with severe persistent asthma were added with montelukast 5 mg/d orally, children accompanied with allergic rhinitis were added with nasonex 100 - 200 g/d intranasal. And four weeks later, all of the patients were given a 12-week observation. Group A kept on treating with seretide （the same doso as before）, and azithromycin 7. 5 mg/ （ kg -d） （ the maximal dose was 250 mg/d） orally was administered intermittently twice a week. Group B kept on treating with seretide （the same dose as before） only. At the end of the study, we assessed the number of days with asthmatic symptoms in two groups respectively. At the beginning and the end of the study, we measured the forced expiratory volume in one second （ FEV1% ）, peak expiratory flow （ PEF% ）, the PDz0-FEV1 by histamine challenged at the 15 th day and at the end of the study in two groups. Twenty-four hours before the study and twenty-four hours after the study, we measured the 24-hour urinary 17-OHCS and 17-KS of the patients. Two weeks after the study, we measured the serumal ALT and AST of the patients. Results （1） The number of days with asthmatic symptoms was （2.13±1.18） dand （2.25±1.19） d respectively in Group A and B, and there was no significant difference between two groups （ t = 0. 54, P=0.59）. （2） The PEF% before and after the study in Group A was （49.77 ±15.02）% and （82.73 ± 7.81 ） % respectively （ t = 16. 59, P =0. 000）. The PEF% before and after the study in Group B was （52. 69 ± 13.90）% and （81.15±7. 28）% respectively （t = 12. 37, P =0. 000）. The FEV% before and after the study i

关 键 词：大环内酯类 阿奇霉素 哮喘 气道反应性 

分 类 号：R725.6[医药卫生—儿科]