MIST方案预防儿童支气管哮喘急性发作的疗效观察  

Efficacy of MIST regimen in preventing acute attack of bronchial asthma in children

作　　者：刘剑平 周瑞芳[2] 陈秋萍 LIU Jianping;ZHOU Ruifang;CHEN Qiuping(Department of Pediatrics,Affiliated People's Hospital of Taizhou,Nanjing Medical University,Taizhou 225300,CHINA)

机构地区：[1]南京医科大学附属泰州人民医院儿科,江苏泰州225300 [2]泰州职业技术学院医学技术学院

出　　处：《江苏医药》2023年第6期587-590,共4页Jiangsu Medical Journal

基　　金：泰州市人民医院科研基金项目(ZL201927)。

摘　　要：目的观察MIST方案预防儿童支气管哮喘急性发作的疗效。方法接受吸入性糖皮质激素(ICS)在内的支气管哮喘规范化控制至少1个月的支气管哮喘患儿220例随机均分为MIST方案预防(A)组和常规治疗(C)组,每组110例。出现支气管哮喘急性发作先兆征象时,A组给予吸入用布地奈德混悬液1 mg,每日2次,连用7 d;C组仅给予抗感染对症处理。随访9个月,记录急性上呼吸道感染、急性支气管炎及支气管哮喘急性发作例次。记录两组入组前和随访3、6、9个月时的呼出气一氧化氮(FeNO)水平。结果A组99例和C组100例获得有效随访。随访9个月期间,两组急性上呼吸道感染、急性支气管炎和支气管哮喘急性发作例次比较均无统计学差异(P>0.05)。两组支气管哮喘急性发作均发生在支气管哮喘规范化控制3个月内。与入组前比较,两组随访3、6、9个月FeNO水平均降低(P<0.01),但两组FeNO水平比较无统计学差异(P>0.05)。结论对于正在接受ICS在内的支气管哮喘规范化控制的支气管哮喘患儿,MIST方案不能有效预防后续可能发生的支气管哮喘急性发作。Objective To observe the efficacy of MIST regimen in preventing acute attack of bronchial asthma in children.Methods A total of 220 children with bronchial asthma who had received standardized control of inhaled corticosteroids(ICS)for at least one month were randomly divided into groups of A(MIST prevention,110 cases)and C(conventional treatment,110 cases).When the signs of acute attack of bronchial asthma appeared,group A was given 1 mg of inhaled budesonide suspension,twice a day for 7 days.Group C was only given anti-infective symptomatic treatment.The children were followed up for 9 months and the numbers of case with acute upper respiratory tract infection,acute bronchitis and acute attack of bronchial asthma were recorded.The levels of exhaled nitric oxide(FeNO)were compared between the two groups at the time points of before enrollment and 3,6 and 9 months of follow-up.Results Ninety-nine cases in group A and 100 cases in group C were effectively followed up.During the 9-month follow-up period,there were no significant differences in the numbers of case with acute upper respiratory tract infection,acute bronchitis and acute attack of bronchial asthma between the two groups(P<0.05).Acute attack of bronchial asthma in both groups occurred within 3 months of standardized control of bronchial asthma.After 3,6 and 9 months of follow-up,the levels of FeNO in both groups were decreased(P<0.01),which were not significantly different between the two groups(P<0.05).Conclusion In the children with bronchial asthma undergoing standardized control of bronchial asthma including ICS,the MIST regimen is not effective in preventing possible subsequent acute episodes of bronchial asthma.

关 键 词：支气管哮喘 吸入性糖皮质激素 布地奈德 

分 类 号：R725[医药卫生—儿科]