从400例哮喘患儿的治疗看实施《全球哮喘防治创议》的问题及对策

The Problems and Countermoves on Performing the Plan of Global Initative for Asthma in 400 Children with Bronchial Asthma

目的 :探讨当前实施《全球哮喘防治创议》的问题及对策。方法 :对 40 0例哮喘患儿在治疗满 1年时进行横断面研究 ,分析其坚持吸入皮质激素的时间及其与疗效的关系 ,并调查其中中断吸入皮质激素患儿的原因。结果 :全年吸入皮质激素 15 2例 ,<3个月 12 3例 ,～6个月 5 0例 ,～12个月 75例。后 3组 1年内哮喘发作次数、因哮喘而住院次数明显高于全年吸入者 ,而最大呼气流速恢复至正常预计值者则显著低于坚持全年吸入者。 2 48例不能坚持全年吸入者 ,绝大部分是由于家长对吸入激素的意义或要求不理解 ,或由于顾忌药物副作用。结论 :实施《全球哮喘防治创议》方案 ,关键在于抓住吸入皮质激素这一要领即能取得显著治疗效果。

Objective:To explore the present problems and countermoves on performing the plan of global initative for asthma (GINA).Methods:The study of cross section was used when 400 children with bronchial asthma were treated for one year.The relationship between their inhalant time of glucocorticoid and the clinical effect was analyzed,and the causes of the stopping inhalation of glucocorticoid among children were investigated.Results:There were 152 children with bronchial asthma to inhale glucocorticoid for one year,123 children in 3 months,50 from 3 to 6 months and 75 from 6 to 12 months.The frequencies of asthma attack and the times of hospitalization out of that were significantly higher in children of later three groups than in children inhaling glucocorticoid all the year.The children who returned to the normal predicted value of peak expiratory rate of flow(PEF) in later three groups were greatly less than children inhaling glucocortcoid all the year.Owing to the parents' factors,most of children could insistently not inhale glucocorticoid all the year.Conclusion:The key to perform the plan of GINA is to grasp the point of inhaling glucocortcoid.