哮喘儿童持续吸入激素治疗对骨代谢指标的影响

Effects of continuous inhaled corticosteroid on biochemical markers of bone metabolism in children with asthma

目的 观察持续小剂量吸入糖皮质激素对哮喘儿童骨代谢指标的影响。方法 随机将 4 5例 5～ 8岁哮喘患儿分为 3个开放治疗组 ,每天吸入糖皮质激素布地奈得 (BUD)分别是 10 0、2 0 0和 30 0μg,持续 12个月。于治疗开始、第 6和第 12个月临床评估和测量肺功能 FEV1 ;检测血清骨钙素 (OST)、血清胰岛素样生长因子 - (IGF- )、血骨碱性磷酸酶 (BAL P)和尿脱氧吡啶 (DPD) /尿肌酐 (Cr)水平。结果 哮喘患儿治疗后临床评分和肺功能 FEV1 明显改善 ;血清 OST稍高于正常儿童对照组 ,但无显著性差异 ;BAL P高于正常儿童对照组差异显著 ;血清 IGF- 水平与同龄正常儿童比较增高显著 ;尿 DPD/ Cr水平低于正常儿童对照组有显著性差异。结论 持续小剂量吸入糖皮质激素对哮喘儿童的骨代谢指标无明显抑制影响。

Objective This study was performed to observe the effects of long-term treatment with inhaled corticosteroid on bone biochemical markers in children with asthma.Methods The design was a randomized,parallel group study with three low dosing regiments of 100,200,and 300μg of budesonide per day in 45 children(26 males,19 females) with asthma aged 5~8 years old.Each dose group received budesonide for 12 months.Prior to inhaled corticosteroid therapy,6 months and 12 months later,clinical effects were observed and lung function(FEV 1)was measured in patients simultaneously;concentration of serum osteocalcin(OST),insulin-like growth factorⅠ(IGF-Ⅰ),bony alkaline phosphatase(BALP) and urinary deoxypyridinolin versus creatinine (DPD/Cr)were measured.Results After treatment,clinical evaluation was improved and there was significant increase in FEV 1 in asthmatic children.There was no significant difference between the patients group ane the normal control group though the patient had slightly increased amounts of serum OST;there was significant increase in serum BALP and serum IGF-I in asthmatic children after treatment;compared with normal children at the same age group;while decrease in urinary DPD/Cr in patients after treatment.Conclusion Long-term treatment with low-dose corticosteroid wouldn't significantly affect bone metabolism in children with asthma.