CAJ | 학술논문

目的探讨吸入型糖皮质激素(ICS)对急性哮喘发作患儿的治疗效果.方法选择就诊于湖南省儿童医院的中、重度哮喘急性发作患儿80例,使用随机数字表法将患儿分为吸入激素组和常规治疗组,各40例.2组患儿均以氧动雾化吸入法吸入0.5％沙丁胺醇(150μg/kg,最大剂量为每次5 mg)、0.025％溴化异丙托品(250 μg),在此基础上吸入激素组以氧动雾化吸入法吸入0.05％布地奈德,常规治疗组以氧动雾化吸入法吸入0.9％氯化钠注射液,均吸入2 ml,30 min 1次,连续3次.分别于治疗前,治疗后0、1、2h检测并比较2组患儿肺通气功能[包括FEV1(第1秒用力呼气容积)和FEV1％(FEV1/用力肺活量)]、心率、呼吸频率、经皮测血氧饱和度(SaO2)和临床症状评分(CS)差异.结果治疗后2h,吸入激素组CS明显低于常规治疗组,差异有统计学意义[(0.00±0.00)分比(0.55±0.20)分](Z =3.418,P=0.021),完全缓解率明显高于常规治疗组,差异有统计学意义[95.0％ (38/40)比47.5％ (19/40)](x2=22.029,P＜0.001).2组治疗后心率、呼吸频率和SaO2差异无统计学意义(P＞0.05).吸入激素组有5例需要全身用糖皮质激素(12.5％),常规治疗组有10例需要全身用糖皮质激素(25.0％),差异有统计学意义(x2=3.114,P=0.028).吸入激素组有1例需要住院治疗,常规治疗组有5例需要住院治疗.结论采用高剂量、短时间间隔雾化吸入ICS可与吸入的支气管舒张剂发挥协同作用,有效缓解儿童中、重度急性哮喘病情,改善肺功能,降低全身糖皮质激素的使用率和住院例数.
목적 탐토흡입형당피질격소(ICS)대급성효천발작환인적치료효과.방법 선택취진우호남성인동의원적중、중도효천급성발작환인80례,사용수궤수자표법장환인분위흡입격소조화상규치료조,각40례.2조환인균이양동무화흡입법흡입0.5％사정알순(150μg/kg,최대제량위매차5 mg)、0.025％추화이병탁품(250 μg),재차기출상흡입격소조이양동무화흡입법흡입0.05％포지내덕,상규치료조이양동무화흡입법흡입0.9％록화납주사액,균흡입2 ml,30 min 1차,련속3차.분별우치료전,치료후0、1、2h검측병비교2조환인폐통기공능[포괄FEV1(제1초용력호기용적)화FEV1％(FEV1/용력폐활량)]、심솔、호흡빈솔、경피측혈양포화도(SaO2)화림상증상평분(CS)차이.결과 치료후2h,흡입격소조CS명현저우상규치료조,차이유통계학의의[(0.00±0.00)분비(0.55±0.20)분](Z =3.418,P=0.021),완전완해솔명현고우상규치료조,차이유통계학의의[95.0％ (38/40)비47.5％ (19/40)](x2=22.029,P＜0.001).2조치료후심솔、호흡빈솔화SaO2차이무통계학의의(P＞0.05).흡입격소조유5례수요전신용당피질격소(12.5％),상규치료조유10례수요전신용당피질격소(25.0％),차이유통계학의의(x2=3.114,P=0.028).흡입격소조유1례수요주원치료,상규치료조유5례수요주원치료.결론 채용고제량、단시간간격무화흡입ICS가여흡입적지기관서장제발휘협동작용,유효완해인동중、중도급성효천병정,개선폐공능,강저전신당피질격소적사용솔화주원례수.
Objective To evaluate the effect of inhaled glucocorticosteroid (ICS) in treatment of acute episode of childhood asthma.Methods Totally 80 children with moderate to severe acute episode of asthma were enrolled and randomly divided into ICS group (40 cases) and control group (40 cases).All the children were administrated with nebulized 0.5％ salbutamol (150 μg/kg,maximum dose of 5 mg/time) ±0.025％ ipratropiun bromide (250 μg);in addition,ICS group received nebulized 0.05％ budesonide and control group received nebulized 2 ml saline chloride (at half-hourly interval for 3 times,respectively).The lung function,respiratory rate (RR),heart rate (HR),oxygen saturation (SaO2) and clinical score (CS) were tested and compared between the two groups before and 0,1,2 h after treatment.Results After treatment,the CS,RR,SaO2,FEV1 and FEV1 ％ in the two groups were all improved.Two hours after treatment,the CS in ICS group was much lower than that in control group [(0.00 ± 0.00) scores vs (0.55 ± 0.20) scores,Z =3.418,P =0.021].There were no significant differences in RR,HR and SaO2 between two groups (P ＞ 0.05) after treatment.Two hours after treatment,the complete remission rate of ICS group was much higher than that of control group [95.0％ (38/40) vs 47.5％ (19/40)] (x2 =22.029,P＜0.001).Five cases (12.5％) in ICS group and 10 cases (25.0％) in control group required systemic hormone therapy with statistical differences (x2 =3.114,P =0.028);1 case in ICS group and 5 cases in control group required hospitalization.Conclusion Using of nebulized ICS with high dose and short interval and bronchodilators can effectively relieve the clinical symptoms,improve the lung function,reduce glucocorticosteroid and hospitalization in acute moderate to severe exacerbation of childhood asthma.