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Chest:激素雾化吸入可降低重度急性发作哮喘患儿的住院率

2014-05-06 佚名 dxy

激素吸入是哮喘维持期的常规用药,且疗效确切。高剂量激素吸入也是哮喘急性发作时的推荐用药。为明确急性发作时加用高剂量(1500μg)激素吸入治疗是否可降低哮喘患儿的住院率,来自沙特阿拉伯国王大学的Alangari博士等开展了一项研究。结果表明,高剂量激素雾化吸入可降低重度急性发作的哮喘患儿的住院率。文章发表于近期的Chest杂志上。 该项随机双盲安慰剂对照的研究,采用5-15分的临床评分对哮喘急性

激素吸入是哮喘维持期的常规用药,且疗效确切。高剂量激素吸入也是哮喘急性发作时的推荐用药。为明确急性发作时加用高剂量(1500μg)激素吸入治疗是否可降低哮喘患儿的住院率,来自沙特阿拉伯国王大学的Alangari博士等开展了一项研究。结果表明,高剂量激素雾化吸入可降低重度急性发作的哮喘患儿的住院率。文章发表于近期的Chest杂志上。

该项随机双盲安慰剂对照的研究,采用5-15分的临床评分对哮喘急性发作的严重程度进行评估,8-11分为中度发作,≥12分则为重度发作。723例2-12岁因中-重度急性发作到急诊科就诊的患儿被纳入研究,其中139例患儿因多次发作重复入选,共收集到906份患者数据。

入选患者在治疗初期常规接受口服激素、沙丁胺醇和异丙托溴铵治疗,随后随机分入高剂量的激素(1500μg)雾化治疗组和安慰剂组,每20分钟进行一次面罩雾化吸入,共持续1小时。研究人员在治疗后第2、3、4小时判断患者是否需要住院治疗。主要研究指标为治疗后4小时的住院率,次要研究指标为哮喘症状积分的改变和在急诊室的留院观察时长。

结果发现,在总体住院率上,布地奈德雾化组中与安慰剂组无差别(16.4% vs 18.3%)。然而在临床症状积分≥13的患儿中,布地奈德雾化吸入组的住院率显著低于安慰剂组(35.5% vs 53.4%)。

两组患儿治疗期间哮喘症状积分的改善无差别,但重度急性发作的哮喘患儿经布地奈德雾化吸入后症状积分的改善幅度更大。两组患儿的急诊留观时长无差别。

研究表明,在常规治疗基础上,加用布地奈德雾化虽不能降低急性发作哮喘患儿的总体住院率,但却能够降低重度急性发作哮喘患儿的住院率。

原始出处

Alangari AA, Malhis N, Mubasher M, Al-Ghamedi N, Al-Tannir M, Riaz M, Umetsu DT, Al-Tamimi S.Budesonide Nebulization Added to Systemic Prednisolone in The Treatment of Acute Asthma in Children: Double-Blind, Randomized, Controlled Trial.Chest. 2014 Jan 2.


 

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    2014-08-10 cjyisheng

    有临床意义。

    0

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    2014-12-08 Smile2680
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AJRCCM:抑郁增加成人发生哮喘的风险

抑郁是一种常见的精神疾病,15.7%的美国成人曾被诊断患有抑郁症,目前患病率为8.7%。相似的,哮喘也影响着3950万美国人,每年因成人哮喘所支付的医疗费用达180亿美元。在美国,抑郁和哮喘是负担最高的两种疾病。 横断面研究显示哮喘与抑郁之间存在联系,但联系的时序性尚未明确。精神健康问题可能影响哮喘治疗的认知和顺应性,因此抑郁可能与哮喘控制不良及哮喘发作增加相关。慢性应激时下丘脑-垂体-肾上腺轴

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