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小剂量持续吸入丙酸氟替卡松气雾剂对儿童哮喘的疗效及对骨代谢的影响
作者:陈方  陈全景 
单位:湖北医药学院附属东风医院 儿童医疗中心, 湖北 十堰 442001
关键词:支气管哮喘 儿童 丙酸氟替卡松气雾剂 肺功能 骨代谢 
分类号:R562.25
出版年·卷·期(页码):2019·38·第十期(1218-1222)
摘要:

目的:探讨小剂量丙酸氟替卡松雾化持续吸入对支气管哮喘患儿肺功能指标、骨代谢指标、骨密度、生长发育的影响。方法:选取中度持续支气管哮喘儿童40例作为治疗组,予小剂量丙酸氟替卡松气雾剂持续吸入1年,选取同一时期体检正常的40例儿童作为对照组。观察两组研究对象肺功能变化,检测并比较两组骨代谢指标、骨密度、生长发育的变化。结果:两组研究对象研究前(入组时)及与治疗组治疗后同时间点FVC、FEV1/FVC、PEF重复测量结果显示,组间和时间有交互效应(P<0.05),治疗组FVC、FEV1/FVC、PEF显著低于对照组(均P<0.05),治疗组血钙、血磷、碱性磷酸酶、骨钙素、骨密度较治疗前和对照组均无明显变化(P>0.05)。且两组儿童身高和体重均无明显改变。结论:支气管哮喘儿童长期小剂量吸入丙酸氟替卡松气雾剂疗效显著,并对其骨代谢指标、骨密度、生长发育无不良影响。

Objective:To investigate the effect of low-dose fluticasone propionate inhalation on pulmonary function, bone metabolism, bone density, growth and development in children with bronchial asthma.Methods:Forty children with moderate persistent bronchial asthma treated with continuous inhalation of low dose fluticasone propionate aerosol for one year were served as therapeutic group, while 40 children of normal physical examination in the same period were selected as control group. Changes in pulmonary function, bone metabolism, bone density and growth and development in the two groups were compared and observed.Results:Repeated determination of FVC, FEV1/FVC and PEF at the same time point before and after treatment showed that there were interactions between the groups and time points(P<0.05). The levels of FEV1/FVC and PEF in the therapeutic group were significantly lower than those in the control group(P<0.05). There were no significant changes in serum calcium, serum phosphorus, alkaline phosphatase, osteocalcin and bone mineral density in the therapeutic group(P>0.05). And there were no significant changes in height and weight in the two groups. Conclusion:Long-term low-dose inhalation of fluticasone propionate aerosol for children with bronchial asthma is effective, and has no adverse effects on bone metabolism, bone density and growth development.

参考文献:

[1] XIANG L,ZHAO J,ZHENG Y,et al.Uncontrolled asthma and its risk factors in Chinese children:a cross-sectional observational study[J].J Asthma,2016,53(7):699-706.
[2] ZHOU X,HONG J.Pediatric asthma management in China:current and future challenges[J].Pediatric Drugs,2018,20(2):105-110.
[3] 黄肖梅,黄卫娟,陈建江,等.沙美特罗替卡松单用与丙酸氟替卡松联合孟鲁司特钠治疗儿童中度持续哮喘的疗效比较[J].中国药房,2016,27(23):3240-3243.
[4] STEMPEL D A,SZEFLER S J,PEDERSEN S,et al.Safety of adding salmeterol to fluticasone propionate in children with asthma[J].N Engl J Med,2016,375(9):840-849.
[5] 中华医学会儿科学分会呼吸学组.儿童支气管哮喘诊断与防治指南(2016年版)[J].中华儿科杂志,2016,54(3):167-181.
[6] 安倍莹,李亚男,具杨花,等.哮喘患儿血清中维生素D3水平对哮喘控制和肺功能的影响及其临床意义[J].吉林大学学报(医学版),2018,44(5):1010-1013.
[7] 刘传合.儿童支气管哮喘诊断与管理的新观点——2014-2015年全球哮喘防治创议的启示[J].中华实用儿科临床杂志,2015,30(16):1223-1226.
[8] CAZEIRO C,SILVA C,MAYER S,et al.Inhaled corticosteroids and respiratory infections in children with asthma:a meta-analysis[J].Pediatrics,2017,139(3):e20163271.
[9] SHER L,YIU G,SAKOV A,et al.P139 Fluticasone propionate and fluticasone/salmeterol multidose dry powder inhalers compared with placebo for persistent asthma[J].Allergy Asthma Proc,2017,38(5):343-353.
[10] ZHANG L,PRIETSCH S O,DUCHARME F M.Inhaled corticosteroids in children with persistent asthma:effects on growth[J].Evid Based Child Health,2014,9(4):829-930.
[11] 董威,王健,贾国兴,等.抗凝联合他汀类降脂药治疗激素性股骨头坏死大鼠模型疗效及机制研究[J].东南大学学报(医学版),2019,38(1):131-135.
[12] 张琴,刘乃丰.糖基化终产物对人血管平滑肌细胞表达及分泌甲状旁腺激素相关肽和血管钙化的影响[J].东南大学学报(医学版),2014,33(5):545-550.
[13] LJUŠTINAPRIBI,RADMIL A,STOJANOVI,et al.The influence of inhaled fluticasone on bone metabolism and calciuria in asthmatic children[J].J Aerosol Med Pulm Drug Deliv,2011,24(4):201-204.
[14] ADAMCZYK P,PLUSKIEWICZ W,HALABA Z,et al.Quantitative ultrasound measurement at the hand phalanges does not reveal skeletal disturbances in children with bronchial asthma:a longitudinal observation[J].J Ultrasound Med,2017,36(5):975-984.

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