雾化吸入糖皮质激素对哮喘儿童骨代谢与身高的影响

Influence of nebulized corticosteroids on bone metabolism and growth in children with asthma.

【目的】探讨雾化吸入糖皮质激素（inhaled corticosteroids,ICS）对哮喘儿童骨代谢与身高的影响。【方法】1）选择既往未使用过ICS治疗的哮喘儿童30例,在雾化吸入布地奈德（budesonide,BUD）前、后6周测定血清骨钙素,设30例正常健康儿童为对照组;2）选择已规律雾化吸入BUD 1~2年哮喘儿童60例,根据近3个月雾化吸入BUD剂量分为BUD-250组（吸入BUD 250μg）,和BUD-500组（吸入BUD 500μg）,检测其血清骨钙素并测量身高,设30例正常健康儿童为对照组。【结果】1）哮喘儿童组治疗前、治疗6周与健康对照组的血清骨钙素分别为（4.64±0.34）ng/mL、（4.89±0.30）ng/mL和（4.63±0.46）ng/mL,治疗前后的血清骨钙素及与健康对照组差异无统计学意义（P均〉0.05）;2）BUD-250组、BUD-500组和健康对照组血清骨钙素分别为（4.98±0.50）ng/mL（、4.14±0.36）ng/mL和（4.62±0.46）ng/mL,组间比较差异无统计学意义（F=0.92,P=0.40）。BUD-250组、BUD-500组和健康对照组身高SDS值分别为0.29±0.17、0.23±0.15和0.30±0.11,组间比较差异无统计学意义（F=0.05,P=0.95）。【结论】哮喘儿童长期规律雾化吸入250~1 000μg/d BUD对骨代谢和身高无明显影响。

【Objective】 To evaluate the effect of nebulized budesonide（BUD） in recommended dose on the level of serum osteocalcin and height. 【Methods】 1）30 steroid-nave children with mild to moderate persistent asthma（observation group） were treated with Budesonide inhaled suspension（BIS）,Before and 6 after weeks treatment the level of serum osteocalcin were measured and compared with those in normal children.2）60 asthmatic children who had regularly treated with BIS through jet nebulizer for more than 12 months was divided into two groups： BUD-250 group and BUD-500 group（those asthmatic children who had received 250 μg/d or 500 μg/d of BIS for more than 3 months respectively.） The levels of serum osteocalcin and height were measured and compared with those in normal children. 【Results】 1）In asthmatic children group,before and 6 after weeks the nebulized BIS treatment,the levels of serum osteocalcin were（4.64±0.34）ng/mL and（4.89±0.30）ng/mL（P0.05）.The level of serum osteocalcin in healthy children were（4.63±0.46）ng/mL.Comparing with those in asthmatic children,no matter whether it was before or after the treatment,no significant difference statistically was found in serum osteocalcin.2）In BUD-250 group and BUD-500 group,the levels of serum osteocalcin was（4.98±0.50）ng/mL and（4.14±0.36）ng/mL,respectively.and the heigh SDS was（0.29±0.17） and（0.23±0.15）,respectively.Comparing with the serum osteocalcin [（4.62±0.46）ng/mL] and the heigh SDS（0.30±0.11） in normal children,again,no significant difference statistically were found. 【Conclusion】 Nebulized BIS in recommended dose（250～1 000 μg/d）as long-term treatment would not significantly change the level of serum osteocalcin and height in children with asthma.