间歇吸入布地奈德预防年幼儿喘息反复发作的疗效观察

Observation on the efficacy of intermittent inhalation of budesonide suspension in preventing recurrent wheezing of young children

目的观察间歇性雾化吸入布地奈德混悬液预防年幼儿喘息反复发作的疗效。方法 100例反复喘息患儿,其中哮喘预测指数(API)阳性患儿50例,随机分为A组和B组,每组25例;API阴性患儿50例,随机分为C组和D组,每组25例。A、C组患儿采取间歇吸入布地奈德干预方案:在患儿出现呼吸道症状时立即雾化吸入布地奈德混悬液;B、D组患儿采取常规治疗方案:在患儿有喘息发作时雾化吸入布地奈德混悬液。随访1年,比较A、B组及C、D组喘息发生率、无喘息例数占比。结果随访1年, A组患儿喘息发生率18.5%低于B组的38.8%,无喘息例数占比64.0%高于B组的20.0%,差异具有统计学意义(P<0.05); C组喘息发生率、无喘息例数占比与D组比较差异无统计学意义(P>0.05)。结论间歇雾化吸入布地奈德混悬液预干预API阳性反复喘息患儿能有效预防喘息反复发作,对API阴性反复喘息患儿不能起到预防作用。

Objective To observe the efficacy of intermittent inhalation of budesonide in preventing recurrent wheezing of young children. Methods Among 100 children with recurrent wheezing, 50 children with positive asthma prognostic index(API) were randomly divided into group A and group B, with 25 cases in each group, and 50 children with negative API were randomly divided into group C and group D, with 25 cases in each group. Pre-intervention program of intermittent inhalation of budesonide was adopted in group A and C: budesonide suspension was inhaled by atomization immediately when respiratory symptoms occurred in children;routine treatment was adopted in group B and D: budesonide suspension was inhaled by atomization when wheezing attack occurred in children. After 1 year of follow-up, the incidence of wheezing and the proportion of non-wheezing in group A, B, and C and D were compared. Results After 1 year of follow-up, group A had lower incidence of wheezing as 18.5% than 38.8% in group B, and higher proportion of non-wheezing as 64.0% than 20.0% in group B. Their difference was statistically significant(P<0.05). Group C had no statistically significant difference in incidence of wheezing and proportion of non-wheezing(P>0.05). Conclusion Intermittent nebulization inhalation of budesonide suspension pre-intervention for children with API positive recurrent wheezing can effectively prevent recurrent wheezing, but can not prevent children with API-negative recurrent wheezing.