高压氧综合治疗对激素依赖性哮喘患者血浆皮质醇的影响  

Effect of comprehensive hyperbaric oxygen on plasma cortisol of the patients with hormone - dependent asthma

作　　者：孟冰 窦金丽 姜美芳 李国华 王桂平 梁晓荣 扬永明 

机构地区：[1]潍坊哮喘病医院高压氧科,山东省潍坊261041 [2]潍坊哮喘病医院呼吸科,山东省潍坊261041

出　　处：《中华航海医学与高气压医学杂志》2012年第4期220-223,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨高压氧（hyperbaric oxygen，HBO）联合药物治疗对激素依赖性哮喘患者血浆皮质醇（cortisol，Cor）的影响。方法经患者知情同意，采用随机单旨法将符合入选标准的患者分为HBO组有效病例54例）和对照组（有效病例48例）。HBO组患者在常规治疗的基础上加HBO治疗，对照组采用常规治疗，分别于治疗前及治疗1、2、3个疗程后测定Cor和促肾上腺皮质激素（adrenocorticotropic hormone，ACTH）的含量，并进行哮喘控制测试评分，记录不良反应和激素撤停反应。结果HBO组患者治疗后各时间点血浆Cor均高于对照组（P〈0．05）；2组ACTH于治疗第1个疗程均开始升高，但差异无统计学意义（P〉0．05）。至治疗3个疗程，HBO组[（68．90±13．30）μg/L]与对照组[（30．52±10．50）μg／L]比较差异有统计学意义（P〈0．05）；HBO组症状改善迅速，治疗1个疗程的评分（17．1±1．1）、2个疗程的评分（20．5±1．1）与对照组的评分（12．3±0．8、16．5±1．1）比较差异均有统计学意义（P〈0．05），至治疗3个疗程时虽仍优于对照组，但差异无统计学意义（P〉0．05）。2组不良反应比较差异无统计学意义（P〉0．05），但HBO组激素撤停反应的发生率明显低于对照组（P〈0．01）。结论HBO治疗可有效调节下丘脑-垂体-肾上腺皮质轴，促进ACTH的分泌，使血浆Cor明显升高，可以用于激素依赖性哮喘的治疗。Objective To explore the effects of comprehensive hyperbaric oxygen （HBO） on plasma cortisol of the patients with hormone-dependent asthma. Methods Patients who met the selection criteria were randomly divided into the HBO group and the control group. The patients of the control group were treated with HBO in addition to routine treatment, while the patients of the control group just received routine treatment. Levels of plasma cortisol and adrenocorticotropic hormone （ACTH） were measured just before treatment, after one course of treatment, after two courses of treatment and after three courses of treatment respectively. Then, symptoms were evaluated, side-effects of treatment and adverse effects of cortisol withdrawal reaction were registered. Results The levels of plasma cortisol in patients of the HBO group were all higher tham those of the control group at various time points （ P 〈 0.05 ）. The levels of ACTH in patients of both groups all began to elevate following one course of treatment, but without statistical significance. After three courses of treatment, statistical difference could be noted, when comparisons were made between the HBO group and the control group （ P 〈 0.05 ）. Symptoms of the patients in the HBO group improved rapidly. After one and two courses Of treatments, statistical significance could be noted, when comparisons were made between the two groups （P 〈 0.05 ）. And though it was still superior to that of the control group after three courses of treatments, there was no statistical difference between them （ P 〉 0.05 ）. No differences were shown in side-effects between the 2 groups. However, incidence of cortisol withdrawal reaction in patients of the HBO group was obviously lower than that of the control group （ P 〈 0. 01 ）. Conclusions HBO could effectively regulate hypothalamus- pituitary-adrenal cortex axis, promote the secretion of ACTH and increase the level of plasma cortisol, and it could be used for the treatment of hormone-dependent asthma.

关 键 词：高压氧 激素依赖性哮喘 血浆皮质醇 促肾上腺皮质激素 撤停反应 

分 类 号：R562.25[医药卫生—呼吸系统]