摘要
目的比较儿童哮喘急性发作时雾化吸入不同起始剂量布地奈德+沙丁胺醇及单独静滴甲泼尼龙的临床效果。方法选取66例中重度哮喘急性发作的住院患儿,随机分成A(n=20)、B(n=22)和C(n=24)3个组,A组给予布地奈德+沙丁胺醇雾化吸入,布地奈德<4岁0.5 mg/次,≥4岁1 mg/次,沙丁胺醇2.5 mg/次,1/8 h,连用3 d后改为1/12 h;B组给予布地奈德+沙丁胺醇雾化吸入,布地奈德不管年龄大小1 mg/次,沙丁胺醇2.5 mg/次,1/8 h,连用3 d后减为布地奈德0.5 mg/次,1/12 h;C组静滴甲基强的松龙2 mg/kg,1/8 h,喘息缓解后停用,观察患儿入院后0、8、24、48、72 h临床症状评分,治疗后24 h血气分析,治疗前、治疗后7 d空腹血糖检测结果及不良反应。结果 3组均能有效改善哮喘急性发作症状,而B组和C组能更快地改善症状,尤其是在最初8 h和24 h,差异有统计学意义(P<0.05),B组和C组比较差异无统计学意义,而48 h与72 h 3组间临床症状评分差异无统计学意义,治疗后24 h A组与B、C组血气分析改善情况差异有统计学意义(P<0.05),B组和C组血气分析改善情况差异无统计学意义;空腹血糖A、B组治疗前、治疗后7 d差异无统计学意义,C组治疗前、治疗后7 d差异有统计学意义(P<0.05),不良反应发生率C组最高,差异有统计学意义(P<0.05)。结论对于中重度哮喘急性发作的患儿,高起始剂量布地奈德治疗能更快地控制症状,减少全身激素的使用量,降低全身不良反应,具备较好的安全性。
Objective To investigate the clinical effect of different initial doses of nebulized budesonide inhalation and salbutamol and a separate intravenous injection of methylprednisolone in young children with moderate to severe asthma exacerbations. Methods 66 child patients in this hospital suffering from moderate to severe acute asthma were randomly divided into three groups： group A （n=20）, group B（n=22） and group C （n=24）. Group A were given nebulized budesonide inhalation（0.5 mg each time for under 4 years old, 1mg each time for above 4 years old） and salbutamol（2.5 mg each time） every 8 h for 3 days and then they would be changed to every 12 h. Group B were treated with the same formula as that given to those above 4 years old in group A, with a slight difference in that on the forth day the dose of nebulized budesonide inhalation was reduced to 0.5 mg every 12 h. Group C were given intravenous injection of methylprednisolone, with the formula of 2 mg/kg and every 8 h for 3 d.It would stop using when breathing eased. The clinical symptom scores were made separately at 0, 8, 24, 48 and 72 hours after hospital treatment, blood gas analysis obtained 24 h after treatment,fasting plasma glucose was tested 7 days before and after treatment and adverse reactions were observed. Results Obvious alleviation of acute exacerbation of asthma symptoms was observed among three groups. There was dramatic alleviation occurred in the first 8 h and 24 h for group B/C, and there was statistically significant difference between group A and B/C （P〈0.05）. But the difference between group B and C was not significant. In 48 h and 72 h after treatment, the difference in score among three groups was not statistically significant. Further, in 24 hours after treatment differences in blood gas analysis among group A and B/C was statistically significant （P〈0.05） while the difference in blood gas analysis between group B and C was not statistically significant. For fasting plasma tested after 7 days and befor
出处
《武警医学》
CAS
2014年第3期231-234,共4页
Medical Journal of the Chinese People's Armed Police Force
关键词
哮喘
不同剂量
布地奈德
吸入治疗
甲基强的松龙
空腹血糖
儿童
asthma
different doses
budesonide
inhalation therapy
methylprednisolone
fasting plasma
children
