Kawagishi Y, Oosaki R, Kashii T, Kawasaki A, Fujishita T, Arai N, Yamashita N, Maruyama M, Kobayashi M
First Department of Internal Medicine, Toyama Medical and Pharmaceutical University.
Arerugi. 2000 May;49(5):391-6.
To clarify the prognosis of asthmatics treated with low-dose of inhaled beclomethasone dipropionate (BDP), we retrospectively assessed 43 patients treated with initial dose of 200 or 400 micrograms/day for 5 years, and obtained the following results. 1) 15 patients achieved step-down therapy (group A), 17 patients maintained initial dose of BDP (group B), and 11 patients required step-up therapy of BDP or daily use of oral prednisolone (group C). 2) There was no significant difference in age, sex, duration of disease, severity of disease, peripheral eosinophil counts, %FEV1 and histamine PC20 before BDP treatment among three groups. The percentage of atopic asthmatics was significantly higher in group C than in group A. 3) There was no significant difference in symptom and histamine PC20 between after 1 year state and after 5 years state in three groups. 4) After 1 year from the start of BDP treatment, only 18% patients got symptom free and neither patients exceeded 20,000 micrograms/ml of histamine PC20 in group C. Long-term treatment of low-dose BDP inhalation was effective on mild/moderate asthmatics. Patients requiring step-up therapy had not got sufficient improvement in bronchial hyperresponsiveness after one-year treatment.
为阐明低剂量吸入丙酸倍氯米松（BDP）治疗哮喘患者的预后，我们回顾性评估了43例初始剂量为每日200或400微克并治疗5年的患者，结果如下：1）15例患者实现了降级治疗（A组），17例患者维持BDP初始剂量（B组），11例患者需要BDP升级治疗或每日口服泼尼松龙（C组）。2）三组患者在年龄、性别、病程、病情严重程度、外周嗜酸性粒细胞计数、FEV1百分比和BDP治疗前组胺PC20方面无显著差异。C组特应性哮喘患者的百分比显著高于A组。3）三组患者1年时和5年时的症状及组胺PC20无显著差异。4）BDP治疗开始1年后，只有18%的患者无症状，C组中也没有患者的组胺PC20超过20,000微克/毫升。低剂量BDP吸入长期治疗对轻/中度哮喘患者有效。需要升级治疗的患者在1年治疗后支气管高反应性未得到充分改善。
