间歇吸入布地奈德预防年幼儿喘息反复发作的疗效观察
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摘要
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.
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.
引文
[1]李新霞,马迎民,方秋红.哮喘患者缓解期吸入糖皮质激素治疗依从性调查分析.北京医学, 2012, 34(2):101-103.
[2]Rodrigo GJ, Castro-Rodríguez JA. Daily vs. intermittent inhaled corticosteroids for recurrent wheezing and mild persistent asthma:a systematic review with meta-analysis. Respir Med, 2013, 107(8):1133-1140.
[3]Rivera-Spoljaric K, Chinchilli VM, Camera LJ, et al. Signs and symptoms that precede wheezing in children with a pattern of moderate-to-severe intermittent wheezing. J Pediatr, 2009,154(6):877-811.
[4]申坤玲,邓力,李云珠,等.糖皮质激素雾化吸入疗法在儿科应用的专家共识(2014年修订版).临床儿科杂志, 2014, 32(6):504-511.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016版).中华儿科杂志,2016, 3(54):167-181.
[6]程能能.雾化吸入药物药理学特性.中国实用儿科学, 2016,31(12):884-886.
[7]魏利锋,李精华,褚锋玮.布地奈德间歇雾化吸入治疗对婴幼儿喘息复发及身高、体质量的影响.中国基层医药, 2016,23(17):2659-2661.
[8]翁小斌,鲍金芳,郑青松,等.间歇吸入布地奈德混悬液对喘息婴幼儿肺功能及复发的影响.中国基层医药, 2018, 25(4):495-498.
[2]Rodrigo GJ, Castro-Rodríguez JA. Daily vs. intermittent inhaled corticosteroids for recurrent wheezing and mild persistent asthma:a systematic review with meta-analysis. Respir Med, 2013, 107(8):1133-1140.
[3]Rivera-Spoljaric K, Chinchilli VM, Camera LJ, et al. Signs and symptoms that precede wheezing in children with a pattern of moderate-to-severe intermittent wheezing. J Pediatr, 2009,154(6):877-811.
[4]申坤玲,邓力,李云珠,等.糖皮质激素雾化吸入疗法在儿科应用的专家共识(2014年修订版).临床儿科杂志, 2014, 32(6):504-511.
[5]中华医学会儿科学分会呼吸学组,《中华儿科杂志》编辑委员会.儿童支气管哮喘诊断与防治指南(2016版).中华儿科杂志,2016, 3(54):167-181.
[6]程能能.雾化吸入药物药理学特性.中国实用儿科学, 2016,31(12):884-886.
[7]魏利锋,李精华,褚锋玮.布地奈德间歇雾化吸入治疗对婴幼儿喘息复发及身高、体质量的影响.中国基层医药, 2016,23(17):2659-2661.
[8]翁小斌,鲍金芳,郑青松,等.间歇吸入布地奈德混悬液对喘息婴幼儿肺功能及复发的影响.中国基层医药, 2018, 25(4):495-498.