摘要
目的比较地塞米松和泼尼松治疗儿童支气管哮喘(BA)急性加重的治疗效果。方法选择2013年9月至2017年10月在丽水市人民医院儿科就诊的BA急性加重患儿277例,随机分为地塞米松组138例和泼尼松组139例,分别给予地塞米松(0.5mg/kg)口服每日2次、泼尼松(1.5mg/kg)口服每日2次,疗程5天。比较两组症状持续时间、住院时间、非计划急诊、家长满意度、再住院情况和治疗依从性。同时在治疗后第7天、第15天采用哮喘控制测试量表(ACT)、哮喘生活质量调查表(AQLQ)评价临床症状和生存质量(QOL)。结果地塞米松组和泼尼松组症状持续时间比较差异无统计学意义(P>0.05);两组症状和QOL的混合效应模型组间比较差异均无统计学意义(F值分别为0.315、0.214,P值分别为0.661、0.248);ACT和AQLQ评分的不同时点分析结果显示差异均有统计学意义(F值分别为8.104、5.732,P值分别为0.001、0.027);两组住院时间、非计划急诊率、再住院率、家长满意率和糖皮质激素追加率比较差异均无统计学意义(均P>0.05),地塞米松组治疗依从性评分高于泼尼松组,组间比较差异有统计学意义(t=5.518,P<0.05);两组不良反应发生率分别为4.35%和6.47%,组间比较差异无统计学意义(P>0.05)。结论地塞米松治疗BA急性加重的疗效与5天泼尼松给药方案效果基本相当。
Objective To compare the therapeutic effects of dexamethasone and prednisone on acute exacerbation of bronchial asthma(BA)in children.Methods A total of 277 children with acute exacerbations of BA in the pediatrics department of Lishui People’s Hospital from September 2013 to October 2017 were randomly divided into 138 patients in the dexamethasone group and 139 patients in the prednisone group.The two groups were given dexamethasone(0.5 mg/kg)twice daily and prednisone(1.5 mg/kg)orally twice daily for 5 days,respectively.Symptom duration,hospitalization time,non-emergency plan,parents’satisfaction,rehospitalization and treatment compliance were compared between two groups.Clinical symptoms and quality of life(QOL)after 7 days,15 days treatment were evaluated by asthma control test(ACT)scale and asthma quality of life questionnaire(AQLQ).Results There was no significant difference in the duration of symptoms between the dexamethasone group and the prednisone group(P>0.05).And there was no significant difference between the two groups in the mixed effect model of QOL and QOL(F values were 0.315,0.214,P values were 0.661,0.248,respectively).The results of different time points of ACT and AQLQ scores showed statistically significant differences(F values were 8.104,5.732,P values were 0.001,0.027,respectively).There were no significant differences in unplanned emergency rate,rehospitalization rate,parental satisfaction rate,and glucocorticoid addition rate(P>0.05).The dexamethasone group had higher compliance score than prednisone group and has significant statistically difference(t=5.518,P<0.05).The incidence of adverse reactions in the two groups was 4.35%and 6.47%,and there was no significant difference between the two groups(P>0.05).Conclusion The efficacy of dexamethasone in the treatment of acute exacerbation of BA is similar to that of prednisone for 5 days.
作者
徐勇
周家翠
兰秀聪
林建军
XU Yong;ZHOU Jiacui;LAN Xiucong;LIN Jianjun(Department of Pediatrics,People's Hospital of Lishui,Zhejiang Lishui 323000,China)
出处
《中国妇幼健康研究》
2019年第9期1169-1172,共4页
Chinese Journal of Woman and Child Health Research
关键词
地塞米松
泼尼松
哮喘
急性加重
dexamethasone
prednisone
asthma
acute exacerbation
