不同方式吸入糖皮质激素对咳嗽变异性哮喘儿童的肺功能和炎性介质的影响

Effect of corticosteroids inhalation in different ways on pulmonary function and inflammatory mediators in children with cough variant asthma

目的探讨不同方式吸入布地奈德对咳嗽变异性哮喘(CVA)儿童的疗效、肺功能和血清炎性介质水平的影响。方法选取2012年1月—2015年1月诊断为CVA的儿童80名,其中将40名患儿在规范方式下持续吸入糖皮质激素划分为试验组,将另外40名患儿在间断方式吸入糖皮质激素为对照组,并在儿童治疗前、治疗3和6个月时比较两组儿童的咳嗽症状评分、肺功能和炎性介质指标比较。结果治疗前两组的咳嗽症状、肺功能和炎性介质主要指标比较差异无统计学意义(P>0.05);治疗3和6个月后,试验组和对照组CVA儿童的咳嗽症状评分、肺功能指标和血清炎性介质水平组内比较,差异有统计学意义(P<0.05);试验组的咳嗽症状评分、肺功能指标和血清炎性介质水平均显著优于对照组(P<0.05)。结论规范方式下长期持续吸入布地奈德比间断吸入布地奈德更能够有效地改善CVA儿童的咳嗽症状,降低气道阻塞情况,改善肺功能和血清炎性介质水平。

[Objective]To explore the effect of budesonide inhalation in different ways on efficacy, pulmonary function and inflammatory mediators levels in children with cough variant asthma （CVA）.[Methods]80 children who were diagnosed with CVA from January 2012 to January 2015 were recruited in this study. The experimental group （40 cases） was treated with normative continuous inhalation of glucocorticoid, and the control group （40 cases） was given glucocorticoid by intermittent inhalation. The cough symptom scores, pulmonary function and inflammatory mediators levels of two groups were compared before treatment, after 3 months and 6 months of treatment. [Results]Before treatment, there were no statistically significant differences in cough symptom scores, pulmonary function and inflammatory mediators levels between two groups （P〉0.05）. After 3 months and 6 months of treatment, the differences in cough symptom scores, pulmonary function and inflammatory mediators levels were statistically significant between two groups （P〈0.05）. The cough symptom scores, pulmonary function and inflammatory mediators levels of the experimental group were significantly better than those of the control group （P〈0.05）. [Conclusion]Compared with intermittent inhalation, the long-term normative continuous inhalation of glucocorticoid can effectively relieve the cough symptom of children with CVA, reduce airway obstruction, and improve the pulmonary function and inflammatory mediators levels.