吸入布地奈德对婴幼儿哮喘干预的远期疗效观察

Efficacy Evaluation of Inhalation Budesonide for Treatment of Asthma in Infants

目的评价布地奈德对婴幼儿哮喘的远期疗效.方法对婴幼儿哮喘患儿130例,随机分为3组,A组:用雾化器吸入布地奈德雾化混悬液;B组:使用贮雾罐和面罩,吸入布地奈德气雾剂;对照组:不接受表面激素的吸入治疗.观察期为1年,在第4、12、24、48周随访,记录观察期间的临床症状评分及哮喘急性发作时药物使用的情况.结果与对照组相比,A组和B组明显降低了日间症状评分、夜间症状评分,有更多的无症状天数;显著减少了口服激素和吸入速效β2受体激动剂的需求,减少了哮喘的急性发作.而A组在观察期的第4、12周的治疗效果比B组更明显(p<0.05),两组在观察期的第24、48周的治疗指标的差异则无显著性(p>0.05).结论对于婴幼儿哮喘,吸入布地奈德治疗可使哮喘得到长期的稳定,而使用雾化器吸入布地奈德混悬液,是婴幼儿哮喘的首选吸入方式,吸入技术更易掌握,可以更好地减轻哮喘症状,更早地达到长期稳定.

Objective To evaluate the long - term efficacy of inhation on budesenide for treatment of asthma in infants. Methods This study was a 48 - week, randomized, control open trial in which 130 inflants, who were diagnosed with mild to severe persistent asthma, were enrolled. All cases were collected from pediatric out - patient of the First Affiliated Hospital of Guangzhou Medical College ranging from January 1,2002 to June 30, 2003, and were divided into three groups. Respules group： inhated budesenide inhalation suspension by jet nebulizatioal machine with facial mask. MDI group： inhaled budesenide metered dose inhaler by spacer with facial mask. Control group： not inhaled corticosteroids. Efficacy was assessed by recoding nighttime and daytime symptom scores, the percentage of symptom - free days, the times of worsening asthma, requirement for oral corticosteroids and the daily beta 2 - receptor agonist use on a daily diary card, and all the recording work was repeated four times： on 4th week, 12th week, 24th week, 48th week. Results Resplues group and MDI group were more effective in reducing nighttime and daytime symptom scores , diminishing the exacerbations of asthma, decreasing the need for rescue treatment with beta 2 - receptor ngonists and oral cortlcosteroids, and also having mere percentage of symptom - free days, compared with control group（p 〈 0.001 ）. Respules group produced statistically significant improvement in clinical measurement eificacy for asthma control observed by 4th week and 12th week of treatment period （p 〈 0.05） . But at the end of treatment perind（24th week and 48th week）, there were no differences between resplues group and MDI group （p 〉 0.05 ）. Conclusions The results of this study demonstrate that inhalation budesoide can effectively control the asthma. Budesoide inhalation suspension by Jet nebulizertion is the first time treatment for the infants and young children who are not able to use other inhalationsl devices.