摘要
目的探讨雾化吸入糖皮质激素(ICS)——布地奈德(BUD)对哮喘患儿下丘脑-垂体-肾上腺轴(HPAA)功能的影响。方法1.选择既往未使用过ICS治疗的哮喘儿童30例,在雾化吸入BUD前、雾化吸入BUD6周测定其血清皮质醇、24h尿游离皮质醇(24h-UFC),在雾化吸入BUD后12周测定其血清皮质醇和24h-UFC。30例健康儿童为健康对照组,检测其血清皮质醇和24h-UFC。2.选择已规律雾化吸入BUD6个月～2a、起始剂量1000μg/d,逐渐减量至250μg/d或500μg/d并维持该剂量至少3个月的哮喘儿童60例,根据近3个月雾化吸入BUD剂量分为BUD-250组(吸入BUD250μg)和BUD-500组(吸入BUD500μg),测定其血清皮质醇、24h-UFC。结果1.哮喘组治疗前、治疗6周血清皮质醇分别为(251.94±15.79)nmol/L、(228.83±16.51)nmol/L,24h尿游离皮质醇与尿肌酐比值(24h-UFC/Cr)在治疗前、治疗6周、治疗12周分别为(376.08±66.80)nmol/mmol、(361.96±26.96)nmol/mmol、(358.05±35.41)nmol/mmol,治疗前后血清皮质醇和24h-UFC/Cr比较无统计学差异(Pa>0.05)。健康对照组血清皮质醇和24h-UFC/Cr分别为(238.76±9.30)nmol/L、(333.51±27.87)nmol/mmol,哮喘组治疗前、治疗后血清皮质醇和24h-UFC/Cr与健康对照组比较均无统计学差异(Pa>0.05)。2.BUD-250组、BUD-500组和健康对照组血清皮质醇分别为(255.91±24.02)nmol/L、(264.38±17.36)nmol/L、(236.25±9.76)nmol/L,24h-UFC/Cr分别为(396.44±55.33)nmol/mmol、(361.73±33.60)nmol/mmol、(343.42±27.32)nmol/mmol,3组间血清皮质醇和24h-UFC/Cr比较均无统计学差异(Pa>0.05)。结论按照全球哮喘防治创议推荐方案哮喘儿童长期规律雾化吸入ICS对HPAA功能无明显影响。
Objective To evaluate the effect of nebulized corticosteroid Budesonide （BUD） on hypothalamic--pituitary - adrenal axis（HPAA） in children with asthma. Methods 1. Thirty children with mild to moderate persistent asthma（ observation group） were treated with inhaled BUD, before treatment and 6 weeks after treatment, the levels of serum cortisol and 24 - hour urine free cortisol （24 h- UFC）, were measured and compared with those in healthy children, 12 weeks after treatment another observation of 24 h - UFC was made in BUD treated asthmatic children. 2. Sixty asthmatic children who had regnlarly treated with BUD through jet nebulizer for more than 6 months were divided into 2 groups：BUD -250 group （those asthmatic children who had received 250μg/d of BUD for more than 3 months） and BUD - 500 group （those asthmatic children who had received 500μg/d of BUD for more than 3 months） according to the given dose of BUD at 3 months just before our investigation. The levels of serum cortisol and 24 - UFC were measured in both groups. Results 1. In asthmatic chil- dren group,before treatment and 6 weeks after the nebulized BUD treatment,the levels of serum cortisol was （251.94 ± 15.79） mmol/L and （228.83 ± 16.51 ） nmol/L. Before treatment and 6,12 weeks after the nebulized BUD treatment, the 24 h -UFC/Cr was （376.08 ± 66.80） nmol/mmol, （361.96 ± 26.96） nmol/mmol and （358.05 ± 35.41 ） nmol/mmol, respectively. There was no significant difference statistically before and after the treatment （ P 〉 0. 05 ）. The levels of serum cortisol and 24 h - UFC/Cr in healthy children were （ 238.76 ± 9.30） nmol/L and（333.51 ±27.87） nmol/mmol,respectively. Compared with those in asthmatic children,no matter whether it was before or after the treat- ment,no significant difference was found statistically in serum cortisol and 24 h - UFC/Cr（ Pn 〉 0.05 ）. There was no significant difference statistically between normal children and asthmatic children who had received nebuliz
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第16期1244-1246,共3页
Journal of Applied Clinical Pediatrics
