不同疗程吸入糖皮质激素对毛细支气管炎后哮喘的预防作用研究

Study on the preventive effect of different courses of inhaled glucocorticoids on asthma after bronchiolitis

目的比较不同疗程吸入糖皮质激素对毛细支气管炎后哮喘的预防作用。方法选择我院2010年10月～2011年5月诊治的毛细支气管炎患者113例,将其分为对照组55例和观察组58例,均给予常规治疗+吸入β2受体激动剂+吸入糖皮质激素,对照组在治疗结束时即停用糖皮质激素,观察组在治疗结束后1个月停用糖皮质激素,比较两组患者的临床恢复情况。结果治疗结束时观察组的总有效率为94.8%,对照组为92.7%,差异无统计学意义(P>0.05);治疗后两组患者的肺功能均明显改善(均P<0.05);随访1年,观察组的复发率及哮喘发生率分别为5.2%、1.7%,明显低于对照组的18.2%、14.5%,差异均有统计学意义(均P<0.05)。结论不同疗程吸入糖皮质激素对毛细支气管炎后哮喘的预防作用差异明显,适当延长糖皮质激素的应用临床效果更佳,是首选的药物治疗方案。

Objective To compare the preventive effect of different courses of inhaled glucocorticoids on asthma after bronchiolitis. Methods From October 2010 to May 2011 in our hospital, 113 patients with bronchiolitis were selected and divided into two groups, 55 cases of the control group and 58 cases of observation group, they were given conventional therapy ＋ inhaled β2 agonists ＋ inhaled glucocorticoids, the control group stopped glucocorticoids at the end of treatment, and the observation group stopped glucocorticoids in a month after the end of the treatment, the clinical recovery situation of two groups were compared. Results At the end of treatment, the total effective rate of observation group was 94.8% and the control group was 92.7%, there was no significant difference between two groups （P 〉 0.05）; after treatment, the lung function of two groups were significantly improved （P 〈 0.05）; followed-up one year, the relapse rate and incidence of asth- ma of observation group were 5.2% and 1.7%, significantly lower than 18.2% and 14.5% of the control group, the differ- ences were statistically significant between two groups （P 〈 0.05）. Conclusion Different courses of inhaled corticosteroids in the prevention of asthma after hronchiolitis are significant different, prolonging properly the application time of glucocor- ticoid has a better clinical effect, it is the preferred drug treatment programs.