König P, Shatley M, Levine C, Mawhinney T P
Department of Child Health, University of Missouri, Columbia 65212.
Pediatr Pulmonol. 1992 Aug;13(4):209-14. doi: 10.1002/ppul.1950130407.
Severe bronchopulmonary dysplasia (BPD) is frequently associated with asthma. The combination is often severe enough to necessitate corticosteroid therapy. There are no commercially available nebulizer solutions of corticosteroids for use in infants and young children. Seven infants and small children with very severe BPD and asthma aged 6-24 months, were treated with flunisolide, 187-250 micrograms q.i.d. in the form of nasal spray delivered by nebulizer. After treatment for 2.5-20 months, four patients showed clinical improvement, one initially improved but later deteriorated and died of cardiac failure, and two patients showed no improvement and died within 3 months. The number of days of hospitalization was significantly reduced from 8.4/month to 2.5/month (P less than 0.05). No side-effects were detected and it was felt that the three patients who died, did so as a consequence of very severe BPD and its cardiac consequences. The suspension remained stable for 80 min when mixed with normal saline, cromolyn sodium, albuterol, or acetylcysteine. It is concluded that nebulized flunisolide is a potentially useful treatment for infants and young children with asthma and BPD.
重度支气管肺发育不良（BPD）常与哮喘相关。二者合并存在时往往严重到需要进行皮质类固醇治疗。目前尚无用于婴幼儿的皮质类固醇雾化液上市。7例年龄在6至24个月的患有极重度BPD和哮喘的婴幼儿，接受了雾化吸入氟尼缩松治疗，剂量为187至250微克，每日4次。治疗2.5至20个月后，4例患者临床症状改善，1例最初改善但后来病情恶化并死于心力衰竭，2例患者无改善并在3个月内死亡。住院天数从每月8.4天显著减少至每月2.5天（P<0.05）。未检测到副作用，认为死亡的3例患者是由于极重度BPD及其心脏并发症所致。当与生理盐水、色甘酸钠、沙丁胺醇或乙酰半胱氨酸混合时，该混悬液在80分钟内保持稳定。结论是雾化吸入氟尼缩松对患有哮喘和BPD的婴幼儿可能是一种有用的治疗方法。
