Pedersen S
University of Odense and Department of Pediatrics, Kolding Hospital, Kolding, Denmark.
J Allergy Clin Immunol. 2001 Jul;108(1 Suppl):S40-4. doi: 10.1067/mai.2001.115565.
Several studies have evaluated the effects of childhood use of corticosteroids on growth. In short-term studies, the budesonide (BUD) metered dose inhaler and methylprednisolone (injection) had significant effects on lower-leg growth, whereas terfenadine did not. When two doses of BUD (nasal inhaler, 200 or 400 microg once daily) were compared with placebo, only the 400-microg dose had a significant effect on short-term growth. Intranasal mometasone furoate (MF) (100 and 200 microg) had no significant effect on short-term lower-leg growth. In intermediate studies of 1-year duration, intranasal beclomethasone dipropionate (84 microg twice daily) significantly affected growth rate, whereas in a separate study, 100 microg intranasal MF once daily did not. Long-term growth data come from retrospective studies of children with asthma. In these studies, no significant effect on growth has been demonstrated in children taking inhaled beclomethasone dipropionate or BUD. The reason for the discrepancy between intermediate and long-term studies is unclear and warrants further study. Variables in childhood growth including seasonal variations may make growth difficult to assess. However, because growth suppression has been reported in children receiving inhaled or intranasal corticosteroids, the lowest effective dose of drug with a low systemic absorption ratio should always be used. Overall, there appears to be no growth suppression with 100 microg intranasal MF used once daily in children.
多项研究评估了儿童使用皮质类固醇对生长的影响。在短期研究中，布地奈德（BUD）定量吸入器和甲泼尼龙（注射剂）对小腿生长有显著影响，而特非那定则没有。当将两剂BUD（鼻用吸入器，每日一次200或400微克）与安慰剂进行比较时，只有400微克剂量对短期生长有显著影响。糠酸莫米松鼻喷雾剂（MF）（100和200微克）对短期小腿生长没有显著影响。在为期1年的中期研究中，丙酸倍氯米松鼻喷雾剂（每日两次84微克）显著影响生长速率，而在另一项研究中，每日一次100微克鼻用MF则没有。长期生长数据来自对哮喘儿童的回顾性研究。在这些研究中，吸入丙酸倍氯米松或BUD的儿童未显示对生长有显著影响。中期和长期研究结果存在差异的原因尚不清楚，值得进一步研究。儿童生长中的变量包括季节变化，这可能使生长难以评估。然而，由于已有报道接受吸入或鼻用皮质类固醇的儿童出现生长抑制，应始终使用全身吸收比率低的最低有效剂量药物。总体而言，儿童每日一次使用100微克鼻用MF似乎不会出现生长抑制。
