吸入糖皮质激素治疗轻度持续性哮喘儿童的鉴别指标与疗效观察  

Toidentify demographic,clinical,and atopic characteristics that may modify the inhaled corticosteroid treatment response among children enrolled in the treating children to prevent exacerbations of asthma trial

作　　者：叶滨 刘振豪 曾国平 Ye Bin Liu Zhenao Zeng Guoping(Paediatric Department of Maternal and Child Health Care Hospital of Longchuan County in Heyuan Citys Guangdong 517300, China)

机构地区：[1]广东省河源市龙川县妇幼保健院儿内科,517300

出　　处：《山西医药杂志》2017年第2期135-139,共5页Shanxi Medical Journal

基　　金：广东省河源市科技计划项目(2013-090)

摘　　要：目的确定不同患儿的人口、临床、变应性特征,探究吸入糖皮质激素治疗轻度持续性哮喘儿童的鉴别指标与疗效。方法本项研究共纳入288例患儿,一些基线特征与更严重的哮喘自然病史有一定的关系,皮肤试验结果阳性(P<0.05),可逆性支气管哮喘(P<0.05)或实验中不能达到哮喘完全控制(P<0.01)的患儿,其哮喘控制天数要少于同组对应的患儿。在接受常规治疗(与采用安慰剂治疗进行对比)的患儿中,皮肤测试结果呈阳性的患儿很少频发发作,而皮肤测试结果为阴性的患儿就相对频繁发作多一些。在接受综合治疗(与采用安慰剂治疗进行对比)的患儿中,IgE水平≥350K/mL的患儿要比IgE水平<350K/mL的患儿频繁发作的次数更少一些。在登记之前那年未采用口服糖皮质激素治疗哮喘的患儿要比采用口服糖皮质激素治疗哮喘的患儿频发发作的次数更少一些。在接受吸入糖皮质激素治疗(与采用安慰剂组对比)的患儿中,哮喘控制程度是有差别的。结果随机分配288例患儿。根据恶化时间可确定4例患儿在治疗中获得更好的疗效:气源性致敏原皮试结果阳性,血清IgE水平≥350K/mL和在入学前1年曾口服皮质类固醇。根据哮喘控制天数可确定4例患儿在治疗中获得更好的疗效:男性,气源性致敏原皮试结果阳性,血清IgE水平≥350K/mL和不完全的哮喘控制。结论带有过敏性炎症生理指标和(或)更大哮喘负担的患儿能够通过吸入糖皮质激素治疗取得更好的疗效。同时,需要进一步研究确定这些指标是否可以用来指导个性化治疗。Objective Toidentify demographic, clinical, and atopic characteristics that may modify the inhaled corticosteroid treatment response among children enrolled in the treating children to prevent exacerbations of Asthma trial. Methods This study included 288 patients, some baseline characteristics have certain relations with the more serious natural history of asthma, skin test positive results （ P 〈0.05）, reversible bronchial asthma （ P 〈0.05） or experiment can not achieve complete control of asthma （ P 〈0. 001） patients, the asthma control days less than the same group corresponding to the children. In comparison with the placebo treatment group, the IgE level was associated with at least one significant interaction in the history of oral corticosteroids. In the receiving routine treatment （compared with placebo） in children, children with positive skin test results less frequent seizures, and skin test results were negative with relatively more frequent attacks. In an integrated treatment （compared with placebo） in children with IgE level greater than or equal to 350 K/mL children than the level of IgE 350 K/mL children with frequent episodes of times less. The number of children who did not use oral corticosteroids to treat asthma prior to registration was less frequent than those who received oral corticosteroids for asth- ma. Four traits were associated with gender, skin test status, IgE levels, and at least one significant interaction in asthma control in the 3 treatment groups. The interaction of asthma control was significant in children receiving inhaled corticosteroids （compared with placebo）. Results Two hundred eighty--eight children were randomized. As measured by time to first exacerbation, 4 characteristics identified children who received greater benefit from treatment： positive aeroallergen skin test result, serum immunoglobulin E level of 350 K/mL or more, and history of oral corticosteroid use in the year before enrollment. As measured by asthma control days, 4 cha

关 键 词：哮喘 儿童 吸入型皮质激素 分层分析 

分 类 号：R725.6[医药卫生—儿科]