小剂量布地奈德对儿童支气管哮喘血浆皮质醇水平的作用  

Effects of small doses of budesonide on plasma cortisol levels in children with bronchial asthma

作　　者：林伟军 胡丽娅[1] 吕聪聪[1] LIN Weijun;HU Liya;LV Congcong(Department of Pediatrics,Lishui People's Hospital in Zhejiang Province,Lishui323000,China)

机构地区：[1]浙江省丽水市人民医院儿科,浙江丽水323000

出　　处：《中国现代医生》2020年第25期74-77,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY927)。

摘　　要：目的探讨小剂量布地奈德对儿童支气管哮喘患儿血浆皮质醇水平的作用。方法从2016年1月~2018年12月我院儿科住院部收治的儿童支气管哮喘患儿中随机选取80例,根据入院顺序分为观察组与对照组,对照组采用常规药物治疗,观察组在此基础上给予小剂量布地奈德雾化吸入治疗,对比两组患者临床疗效、临床症状改善情况、气道阻力(Raw)、气道传导率(Gaw)、血浆皮质醇水平变化。结果观察组总有效率92.50%,高于对照组70.00%(P<0.05);观察组患者的哮鸣音、呼吸困难及喘息症状消失时间均短于对照组(P<0.05);治疗后,两组患者Raw均显著下降,且观察组低于对照组(P<0.05),Gaw均显著升高,观察组高于对照组(P<0.05);两组患者治疗前后血浆皮质醇水平组间、组内比较差异均无统计学意义(P>0.05)。结论小剂量布地奈德治疗儿童支气管哮喘效果确切,可有效改善临床症状,降低气道阻力,改善肺功能,且血浆皮质醇水平变化较小,长期使用不会导致下丘脑-垂体-肾上腺轴(HPAA)功能抑制,安全性较高。Objective To investigate the effects of small doses of budesonide on plasma cortisol levels in children with bronchial asthma.Methods 80 children with bronchial asthma admitted and treated at our hospital from January 2016 to December 2018 were selected and divided into the observation group and the control group according to the order of admission.The control group was treated with routine drugs,while the observation group was treated with atomized inhalation of small doses of budesonide.The changes in clinical efficacy,clinical symptom improvement,airway resistance(Raw),airway conductivity(Gaw),and plasma cortisol level of patients were compared between the two groups.Results The overall response rate in the observation group was 92.50%,which was significantly higher than that in the control group 70.00%(P<0.05);the disappearance time of asthma,dyspnea and wheezing in the observation group were significantly shorter than those in the control group(P<0.05);after treatment,Raw decreased significantly in both groups of patients,which was lower in the observation group than that in the control group(P<0.05),while Gaw increased significantly in both groups,which was higher in the observation group than that in the control group(P<0.05);before and after treatment,there was no statistically significant difference in plasma cortisol concentration between and within the two groups of patients(P>0.05).Conclusion Small doses of budesonide in the treatment of children with bronchial asthma has a definite effect,which can effectively improve clinical symptoms,reduce airway resistance,and improve pulmonary function.Moreover,the change in plasma cortisol level is comparatively small,therefore long-term use will not lead to functional inhibition of the hypothalamic-pituitary-adrenal axis(HPAA),and being with higher safety.

关 键 词：小剂量布地奈德 支气管哮喘 血浆皮质醇 气道阻力 

分 类 号：R562.25[医药卫生—呼吸系统]