小剂量糖皮质激素对哮喘患儿生长发育、骨密度及骨代谢的影响研究

Effects of low-dose glucocorticoid on growth and development,bone mineral density and bone metabolism in children with asthma

目的探讨小剂量糖皮质激素对小儿哮喘生长发育、骨密度、骨代谢的影响。方法60例哮喘患儿,根据治疗方式不同分为观察组(32例)和对照组(28例);另选取同期进行儿科保健的30例健康儿童作为健康对照组。哮喘患儿均为症状缓解期,观察组接受规范化哮喘治疗,对照组接受非规范化治疗。比较三组生长发育情况[身高、体重、身高增长速度(GV值)、体重增长速度(WV值)],观察组和对照组骨密度值、骨代谢指标[碱性磷酸酶(ALP)、骨钙素(BGP)、钙(Ca^(2+))、磷(P^(3-))]。结果治疗前,三组的身高和体重比较差异均无统计学意义(P>0.05);观察组治疗后身高、GV值分别为(127.77±12.54)cm、(6.42±1.61)cm/y,对照组分别为(124.13±11.01)cm、(5.08±1.30)cm/y,健康对照组分别为(126.85±12.07)cm、(6.34±1.74)cm/y,三组治疗后GV值比较差异有统计学意义(P<0.05);对照组治疗后身高、GV值最低,观察组与健康对照组治疗后身高、GV值接近。三组治疗后身高、体重、WV值比较差异均无统计学意义(P>0.05)。观察组与对照组治疗前后骨密度值及骨密度增量组间比较差异均无统计学意义(P>0.05)。观察组和对照组治疗前后BGP、ALT、Ca^(2+)、P^(3-)水平组间比较差异均无统计学意义(P>0.05)。结论长期吸入小剂量糖皮质激素治疗小儿哮喘的疗效显著,且不会对患儿生长发育、骨代谢、骨密度造成明显影响。

Objective To discuss the effects of low-dose glucocorticoid on growth and development,bone mineral density and bone metabolism in children with asthma.Methods A total of 60 cases of children with asthma were selected and divided into the observation group(32 cases)and the control group(28 cases)according to different treatment methods.Another 30 cases of healthy children who underwent pediatric health care at the same time were selected as the healthy control group.All asthma children were in symptomatic remission,and the observation group received standardized asthma treatment and the control group received nonstandardized treatment.Comparison was made on growth and development[height,weight,height growth rate(GV value),weight growth rate(WV value)]of the three groups;bone mineral density values,bone metabolic indexes[alkaline phosphatase(ALP),bone glaprotein(BGP),calcium(Ca^(2+)),phosphorus(P^(3-))]between the observation group and control group.Results Before treatment,the differences in height and weight of the three groups were not statistically significant(P>0.05).After treatment,the height and GV values were(127.77±12.54)cm and(6.42±1.61)cm/y in the observation group;(124.13±11.01)cm,(5.08±1.30)cm/y in the control group;(126.85±12.07)cm,(6.34±1.74)cm/y in the healthy control group.There was statistically significant difference in GV values among the three groups after treatment(P<0.05).The control group had the lowest height and GV values after treatment,and the observation group was close to the healthy control group in terms of height and GV values after treatment.The differences in height,weight and WV values after treatment were not statistically significant in all three groups(P>0.05).There was no statistically significant difference in BMD values and BMD increments between the observation and control groups before and after treatment(P>0.05).There was no statistically significant difference between the observation group and the control group for BGP,ALT,Ca2+,and P3-levels before and after treatment(P>0.05).Conclusion Long-term inhalation of low-dose glucocorticoid is effective in the treatment of children with asthma,and it will not have obvious impact on the growth and development,bone metabolism and bone mineral density of children.