糖皮质激素两种给药方式治疗婴幼儿哮喘急性发作的疗效比较

Comparison of the Efficacy of 2 Administration of Routes Glucocorticoid in the Treatment of Infant Acute Asthma Attack

目的:比较糖皮质激素两种给药方式治疗婴幼儿哮喘急性发作的临床疗效及安全性。方法:选取我院哮喘急性发作患儿98例,根据糖皮质激素给药方式分为吸入组和口服组,各49例。吸入组患儿给予吸入用布地奈德混悬液1 ml加至0.9%氯化钠注射液2 ml中,使用氧气驱动雾化吸入10 min,bid;口服组患儿给予醋酸泼尼松片1~2 mg(≤40 mg/d),tid。两组患儿均连续治疗1周。观察两组患儿临床疗效、临床控制率、临床症状消失时间,炎性因子和细胞免疫水平,以及不良反应发生情况。结果:吸入组患儿的临床总有效率(93.87%)高于口服组(87.76%),但差异无统计学意义(P>0.05)。吸入组患儿临床控制率(61.22%)明显高于口服组(48.98%),临床症状消失时间明显短于口服组,嗜酸性粒细胞、血清免疫球蛋白(Ig)E、白细胞介素-4(IL-4)、水平均明显低于口服组,差异均有统计学意义(P<0.05)。吸入组患儿CD4^+、CD8^+、CD4^+/CD8^+水平略高于口服组,但差异无统计学意义(P>0.05)。两组患儿均未见明显不良反应发生。结论:糖皮质激素吸入治疗婴幼儿哮喘急性发作的临床疗效与口服给药相当,但临床控制明显优于口服给药,且能迅速改善患儿临床症状及炎性因子,安全性较高。

OBJECTIVE： To compare the clinical efficacy and safety of 2 administration routes of glucocorticoid in the treatment of infant acute asthma attack. METHODS： 98 children with acute asthma attack selected from our hospital and divided into in-halation group and oral group according to route of administration, with 49 eases in each group. Inhalation group was given Budesonide inhalation suspension 1 ml added into 0.9% Sodium chloride injection 2 ml, 10 rain by oxygen drive atomization inhalation, bid; oral group was given Prednisone acetate tablet 1-2 mg（ ≤40 mg/d）,tid. Both groups received treatment for 1 week. clinical efficacy, clinical control rate, the time of clinical symptom disappearance, the levels of imflammatory factor and cellular immune were all observed in 2 groups, and the occurrence of ADR was also observed. RESULTS ： Clinical total effective rate of in- halation group （93.8%） was higher than that of oral group （87.76%）, without statistical significance （P〉0.05）. Clinical control rate of inhalation group （61.22%） was significantly higher than that of oral group （48.98%）, while the time of clinical symptom disappearance in inhalation group was significantly shorter than in oral group; the levels of eosinophile granulocyte, serum IgE, IL-4 were significantly lower than oral group, with statistical significance （P〈0.05） ; CD4^＋, CD8^＋, CD4＋/CD8^＋ of inhalation group was slighter higher than those of oral group, without statistical significance （P〉0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： Inhalation administration of glucocorticoid is similar to oral administration in the treatment of infant acute asthma attack, but it is better than oral administration in clinical control and can improve clinical symptom and immunologic function fast with good safety.