甲基强的松龙联合静脉丙种球蛋白短程冲击治疗儿童重症哮喘

Treatment of Methyprednisolone and Intravenous Immunoglobulin by short-phase pulse therapy in children's severe asthma

目的:探讨甲基强的松龙和静脉丙种球蛋白短程冲击治疗儿童重症哮喘的疗效及副作用。方法:将65例重症哮喘患儿随机分为治疗组(33例)和对照组(32例),两组患儿均采用综合治疗,对照组在此基础上加用常规剂量的地塞米松;治疗组加用大剂量甲基强的松龙和静脉丙种球蛋白冲击治疗,甲基强的松龙剂量为20mg/(kg.d),静脉滴注,连用3d,静脉丙种球蛋白1g/(kg.d),静脉滴注,连用2d。治疗3d后对两组病例的咳嗽、喘息、肺部啰音持续时间和动脉血气改变、显效率和总有效率和住院时间及副作用进行比较。结果:治疗组在缩短咳嗽、喘息、肺部啰音持续时间、住院时间、改善血气、提高显效率和总有效率等方面均明显优于对照组(P<0.01或P<0.05),副作用轻微。结论:甲基强的松龙联合静脉丙种球蛋白短程冲击治疗儿童重症哮喘,可使症状、体征和动脉血气迅速改善,病程缩短,疗效确切,且方便安全,副作用少,可作为抢救重症哮喘的重要措施。

Objective：To investigate the efficacy and side effects of Methyprednisolone and Intravenous Immunoglobulin by short-phase pulse therapy in treatment of children＇s severe asthma.Methods：65 cases of patients with children＇s severe asthma were randomly divided into treatment group（n=33） and control group（n=32）.The integrated treatment was applied in two groups.In the control group,normal-dose Dexamethasone was administrated.In the treatment group,high dose of pulse therapy of Methyprednisolone and Intravenous Immunoglobulin were administrated,with intravenous drip of Methylprednisolone 20 mg/（kg.d） for three days and intravenous drip of Intravenous Immunoglobulin 1 g/（kg.d） for two days.After three days of treatment,the duration of cough,wheeze and rale and the change of arterial hemoglobin and marked improvement rate,total effective rate,the length of stay and side effects were observed and compared.Results：In the cure to shorten the duration of cough,wheeze,rale and the length of stay,and to improve the marked improvement rate,total effective rate,in the treatment group were significantly better than those of the control group（P0.05 or P0.01）,and with slight side effects.Conclusion：Short-phase pulse therapy of Methyprednisolone and Intravenous Immunoglobulin in treatment of children＇s severe asthma can rapidly improve the symptom,physical sign and arterial hemoglobin.Besides,it can shorten the course of disease and have obvious curative effect and little adverse reaction.What＇s more,it＇s convenient and safe.Therefore,it can be a significant method in emergency treatment of severe asthma.