长期雾化吸入中等剂量与低剂量糖皮质激素对哮喘患儿生长发育、肺功能及内分泌功能的影响  

Impacts of long-term nebulized inhalation of medium and low-dose corticosteroids on growth,development,lung function,and endocrine function in children with asthma

作　　者：高娇娇 刘振奎[1] 曹燕玲 马文霞[1] GAO Jiaojiao;LIU Zhenkui;CAO Yanling;MA Wenxia(Department of Pediatrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院儿科,张家口075000

出　　处：《西北药学杂志》2025年第2期134-140,共7页Northwest Pharmaceutical Journal

基　　金：河北省2024年度医学科学研究课题(编号:20242129)。

摘　　要：目的探究长期雾化吸入中等剂量与低剂量糖皮质激素对哮喘患儿生长发育、肺功能及内分泌功能的影响。方法回顾性收集200例2020年12月—2022年9月在河北北方学院附属第一医院儿科门诊治疗的哮喘患儿的资料进行研究,按照治疗方法分为中等剂量组(n=128)和低剂量组(n=72)。在常规治疗的基础上,中等剂量组患儿雾化吸入布地奈德吸入气雾剂,每次200μg,每日2次;低剂量组患儿雾化吸入布地奈德吸入气雾剂,每次200μg,每日1次,2组患儿均持续吸入至少12个月。检测2组患儿治疗前、治疗3个月、治疗6个月以及治疗12个月后的第1秒用力呼气量(forced expiratory volume in one second,FEV_(1))、FEV_(1)/用力肺活量(forced vital capacity,FVC)、身高、体质量,并计算治疗12个月后的身高增长速率(growth velocity,GV)和体质量增长速率(weight velocity,WV),检测2组患儿治疗前和治疗12个月后的促甲状腺激素(thyroid stimulating hormone,TSH)、卵泡刺激素(follicle-stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)和糖化血红蛋白(glycated hemoglobin,HbAlc)的水平。结果治疗3、6、12个月时的FEV_(1)和FEV_(1)/FVC水平均明显高于治疗前(P<0.05),且2组治疗后各个时间点的FEV_(1)和FEV_(1)/FVC水平比较,差异均无统计学意义(P>0.05);治疗后,2组患儿的身高、体质量均在正常范围内逐渐增长,2组患儿治疗后各个时间点的身高、体质量以及治疗12个月后的GV和WV比较,差异均无统计学意义(P>0.05);2组患儿治疗前以及治疗12个月后的TSH、FSH、LH、E2、ACTH和HbAlc水平均在正常范围内,且2组比较,差异均无统计学意义(P>0.05)。结论长期雾化吸入中等剂量与低剂量糖皮质激素可有效改善哮喘患儿的肺功能,中、低剂量糖皮质激素对患儿的生长发育及内分泌激素水平均无显著影响。Objective To investigate the impacts of long-term nebulized inhalation of medium dose and low dose glucocorticoids on growth and development,lung function,and endocrine function in children with asthma.Methods Data from 200 children with asthma treated at our pediatric outpatient clinic between December 2020 and September 2022 were retrospectively collected for this study.The participants were categorized according to their treatment regimens into 2 groups:the medium-dose group(n=128)and the low-dose group(n=72).In addition to routine treatment,children in the mediumdose group received nebulized budesonide inhalation at a dosage of 200μg per session,administered twice daily.Conversely,children in the low-dose group inhaled the same dosage of nebulized budesonide,but only once daily,for a continuous duration of at least 12 months in both groups.The first second forced expiratory volumes(FEV_(1)),FEV_(1)/forced vital capacity(FVC),height,and weight of the 2 groups were measured and recorded before treatment,as well as 3,6 and 12 months post-treatment.Additionally,the height growth rate(GV)and weight gain rate(WV)after 12 months of treatment were calculated,the levels of thyroid stimulating hormone(TSH),follicle stimulating hormone(FSH),uteinizing hormone(LH),estradiol(E2),adrenocorticotropic hormone(ACTH),and glycated hemoglobin(HbAlc)were measured and recorded before and 12 months after treatment in both groups.Results The levels of FEV_(1)and FEV_(1)/FVC at 3 months,6 months,and 12 months of treatment were significantly higher than before treatment(P<0.05),and there was no significant difference in FEV_(1)and FEV_(1)/FVC levels between the 2 groups at different time points after treatment(P>0.05);after treatment,the height and weight of children in the 2 groups gradually increased within the normal range,there was no significant difference in height,weight at different time points after treatment,and the GV and WV after 12 months of treatment between the 2 groups(P>0.05);The levels of TSH,FSH,ACTH and HbAlc befo

关 键 词：中等剂量 低剂量 糖皮质激素 哮喘 生长发育 内分泌功能 肺功能 

分 类 号：R974[医药卫生—药品]