de Paz Arranz S, Rodríguez Mosquera M, Fernández Parra B, Santaolalla Montoya M, Herrera Mozo I, Pérez Pimiento A
Unidad de Alergia, Hospital Santa Bárbara, Complejo Hospitalario de Soria, Spain.
Allergol Immunopathol (Madr). 2005 Jul-Aug;33(4):231-4. doi: 10.1157/13077750.
The management of glucocorticoid dependent and resistant asthma encompasses a group of problems, affecting as much control of clinical symptoms as the onset of adverse effects to prolonged use of steroids.
Woman 52 years old, steroid dependent asthma fifteen years ago. She has important adverse effects in consequence of the use of systemic glucocorticoids. The employment of methotrexate attained decrease in the dosage of steroids temporarily. The worsening of the clinical situation and deterioration of secondary effects by use of steroids necessitated treatment with nebulized lidocaine. A 2% solution to initial dosage was administered three times daily. The maximal dosage needed was 80 mg three times daily.
After three months of lidocaine treatment, the patient was able to reduce oral steroids eventually discontinuing these drugs, and the effects secondary to exogenous hypercortisolism disappeared. Moreover, an improvement in clinical symptoms and quality of life was observed with stability in the pulmonary function.
The use of nebulized lidocaine could be useful and provide alternatives in patients with severe asthma.
糖皮质激素依赖型和抵抗型哮喘的管理存在一系列问题，既影响临床症状的控制，也影响长期使用类固醇所产生的不良反应的发生。
一名52岁女性，15年前患类固醇依赖型哮喘。因使用全身糖皮质激素出现了严重的不良反应。使用甲氨蝶呤后，类固醇剂量暂时减少。因使用类固醇导致临床状况恶化和副作用加剧，需要使用雾化利多卡因进行治疗。初始剂量为2%溶液，每日给药3次。最大剂量需要每日3次，每次80毫克。
经过3个月的利多卡因治疗，患者最终能够减少口服类固醇药物并最终停用这些药物，外源性皮质醇增多症的继发效应消失。此外，观察到临床症状和生活质量有所改善，肺功能保持稳定。
雾化利多卡因的使用可能有效，并为重度哮喘患者提供了替代治疗方法。
