长期吸入二丙酸氯地米松对哮喘患者肺功能及HPA轴的影响

EFFECTS OF LONG TERM TREATMENT WITH INHALED BECLOMETHASONE ON THE LUNG FUNCTION AND HYPOTHALAMUS PITUITARY ADRENAL AXIS

观察３６例哮喘患者吸入类固醇激素（二丙酸氯地米松，ＢＤＰ）后对临床症状、肺通气功能、气道高反应性（ＡＨＲ）及下丘脑垂体肾上腺轴（ＨＰＡ）的影响。实验分三阶段进行：第一阶段ＢＤＰ剂量６００～９００μｇ／ｄ，第二阶段３００～４００μｇ／ｄ，第三阶段为停药观察病情转归。第一阶段临床有效率８７５％，ＦＶＣ、ＦＥＶ１．０、ＰＥＦＲ、Ｖ５０及Ｒｒｓ．Ｃ、Ｄｍｉｎ均较治疗前显著改善，Ｓｄ无变化，血浆皮质醇基值无明显降低；第二阶段临床有效率８６１％，ＦＶＣ、ＦＥＶ１．０、Ｖ５０及Ｒｒｓ·Ｃ、Ｄｍｉｎ、Ｓｄ均未能进一步改善，而ＰＥＦＲ明显低于第一阶段，血浆皮质醇基因仍无明显改变。

The effects of long term treatment with inhaled beclomethasone(BDP) on clinical symptoms, lung ventilatory function, airway hyperreactivity (AHR) and hypothalamus pituitary adrenal axis(HPA) were observed in 36 cases of asthma. The study was divided into 3 periods: the first period with BDP doses of 600～900μg per day, the second period with BDP doses of 300～600μg per day and the third period with no BDP taken. In the first period there were significant improvements in FVC,PEV1,PEFR,V50,Rrs and Dmin with 86.5% of clinical effective rate, but no change in Sd and plasma cortisol baseline. In the second period there were no further improvements in FVC,FEV 1.0 , 50 , Rrs·C ,Dmin and Sd, but a decrease in PEFR as compared with the first period. There was no change in the plasma cortisol baseline. The clinical effective rate was 83.9% for the second period. In the third period there was 53.6% of relapse in the patients observed.