长期吸入丙酸氟替卡松对支气管哮喘患者肾上腺皮质功能的影响

The influence of long term inhaled fluticasone propionate on the functions of adrenal cortex in bronchial asthmatic patients

目的 评价长期吸入丙酸氟替卡松 (FP)对哮喘患者肾上腺皮质功能的影响。方法非急性发作期支气管哮喘患者 80例 ,中度 42例 ,重度 38例。使用FP治疗前 1周为筛选期 ,测定早晨 8时血浆皮质醇。中度患者吸入FP气雾剂 50 0 μg/d ,重度患者吸入FP 750 μg/d。治疗期至少 1年以上。治疗结束时测定FEV1 %与PEF ,同时测定早晨 8时的血浆皮质醇。结果 吸入FP50 0 μg/d组治疗前、后早晨 8时血浆皮质醇值分别为 (1 0 8 5± 50 7) μg/L和 (1 0 3 8± 48 1 ) μg/L(P >0 0 5) ;吸入FP 750 μg/d组分别为 (1 0 2 4± 48 6) μg/L和 (1 0 0 5± 51 4) μg/L(P >0 0 5)。两组比较无显著性差异 (P >0 0 5)。两组患者吸入FP 1年后血浆皮质醇值均在正常范围内。结论 长期吸入FP 50 0 μg/d和 750 μg/d对于中、重度哮喘患者均可达到有效的治疗效果 。

Objective To evaluate the safety of long term inhaled fluticasone propionate (FP) on the functions of adrenal cortex of asthmatic patients Methods 80 bronchial asthmatic patients in stable stage were enrolled,among whom 42 patients were moderate and 38 were severe One week before treatment of FP was screening duration in which plasma cortisol level at 8 A M was detected Moderate patients inhaled FP through MDI 500 μg per day and severe patients 750 μg per day The treatment lasted at least one year,after which FEV 1 % and PEF were examined and plasma cortisol level at 8 A M was detected Results Plasma cortisol level at 8 A M of the patients inhaled FP 500 μg per day were (108 5±50 7)μg/L and (103 8±48 1)μg/L before and after the treatment,respectively ( P >0 05) Plasma cortisol at 8 A M of the patients inhaled FP 750 μg per day were (102 4±48 6)μg/L and (100 5±51 4)μg/L before and after the treatment,respectively( P >0 05) After one year,plasma cortisol of the patients in either inhaled FP 500 μg group or 750 μg group was within normal rang Conclusions Long term inhaled FP with 500 μg to 750 μg per day is effective in moderate to severe asthma patients and has no significant suppression on adrenal cortex function