糖皮质激素吸入治疗持续时间对咳嗽变异性哮喘患儿预后的影响

Analysis of the relationship between time of inhaled glucocorticoid treatment and prognostic effect in patients with cough variant asthma.

目的探讨咳嗽变异性哮喘患儿使用糖皮质激素吸入治疗的疗程对其疗效及预后的影响。方法选择2004-02—2005-04就诊于深圳妇幼保健院的84例咳嗽变异性哮喘患儿,应用糖皮质激素吸入治疗,用量250~375μg/d,分2~3次,按应用激素治疗的疗程随机分为超短期组、半年期组和1年期组等三组,超短期组患儿用药1个月。分别在治疗前后测定患儿最大呼气峰流速（PEF）。并观察治疗后2年内患儿的复发情况。结果三组患儿测定的PEF值用药后均较用药前明显改善超短期组由65.06±8.93上升到90.74±5.43,半年期组由65.68±8.92上升到90.71±3.60,1年期组由65.91±8.50上升到89.88±5.89（P〈0.001）。经治疗后,2年内超短期组复发25例,占71.43%;半年期组复发6例,占22.22%;1年期组复发2例,占9.09%,组间比较差异具有显著性（P〈0.001）。结论对咳嗽变异性哮喘患儿,应早期规范使用糖皮质激素吸入治疗,疗效明显。坚持长期吸入治疗可以有效降低患儿远期复发率。

Objective To investigate the relationship between course of treatment of inhaling glucocorticoid and curative ＇and prognostic effect in patients with cough variant asthma. Methods A total of 84 patients with cough variant asthma were treated by glucocorticoid inhalation 250 ~ 375μg · d^ -1 ,2 - 3 times every day. All of them were divided randomly into very-short-month group, the six-month group and the one-year group according to the course of treatment. Then we measured the peak expiratory flow rate （PEFR） at the time of pre-treatment and post-treatment and observed the recurrence in two years. Results The PEFR value of the three groups at post-treatment improved evidently. The PEFR value of the very-short-month group,the six-month group and the one-year group rose from 65.06 ± 8.93,65.68 ± 8. 92,65.91 ± 8, 50 to 90. 74 ± 5.43,90. 71 ± 3.60,89. 88 ± 5.89 （ P 〈 0. 001 ） respectively. Twenty-five patients in the very-shortmonth group recurred, which accounted for 71.43% in two years. Six patients in the six-month group recurred, which accounted for 22. 22%. Two patients in the one-year group recurred, which accounted for 9.09%. Conclusion The patients with cough variant asthma should be treated by inhaled glucocorticoid treatment more early and the long-term treatment could reduce recurrence rate.