Estrada-Reyes Elizabeth, Del Río-Navarro Blanca E, Rosas-Vargas Miguel Angel, Nava-Ocampo Alejandro A
Department of Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, México DF.
Pediatr Allergy Immunol. 2005 Nov;16(7):609-14. doi: 10.1111/j.1399-3038.2005.00317.x.
This study aimed to compare the efficacy of nebulized therapy with salbutamol alone or in combination with fluticasone. In a randomized, double-blind clinical trial, 150 children with moderate acute asthma were randomly assigned to receive by nebulizations either (i) three doses of salbutamol 30 microl/kg per dose, each dose administered every 15 min, (ii) three doses of salbutamol plus two doses of fluticasone 500 microg/dose at 15 and 30 min after first dose of salbutamol, or (iii) three doses of salbutamol/fluticasone 500 microg/dose, each combined dose administered every 15 min. Pulse oxymetry (SaO2), peak expiratory flow (PEF) and Wood et al. (Am J Dis Child, 123, 1972, 123) clinical scale were evaluated at baseline, 15, 30, 45, 60, 90 and 120 min after the first nebulization. Patients in the three groups significantly improved since 15 min after the first nebulization. We did not observe differences in the recovery of SaO2 and PEF among the three groups of treatment (p > 0.10). In group 3, children showed better clinical response at 120 min than the other two groups (p < 0.05). No significant adverse effects were observed with any treatment. To summarize, in children with acute moderate asthma, nebulized salbutamol at an accumulated dose of 90 mul/kg plus fluticasone at an accumulated dose of 1500 microg produced better clinical relief after 2 h. However, similar PEF and SaO2 responses were observed with salbutamol alone or in combination with different doses of fluticasone.
本研究旨在比较单独使用沙丁胺醇雾化治疗与联合氟替卡松雾化治疗的疗效。在一项随机双盲临床试验中，150名中度急性哮喘患儿被随机分配接受雾化治疗，方案如下：（i）每剂30微克/千克的沙丁胺醇，共三剂，每剂间隔15分钟给药；（ii）在第一剂沙丁胺醇给药后15分钟和30分钟，给予三剂沙丁胺醇加两剂500微克/剂的氟替卡松；（iii）每剂500微克的沙丁胺醇/氟替卡松混合剂，共三剂，每剂间隔15分钟给药。在首次雾化治疗后的基线、15、30、45、60、90和120分钟，评估脉搏血氧饱和度（SaO₂）、呼气峰值流速（PEF）以及Wood等人（《美国小儿疾病杂志》，123卷，1972年，第123页）临床量表。自首次雾化治疗15分钟后，三组患者均有显著改善。我们未观察到三组治疗在SaO₂和PEF恢复方面存在差异（p>0.10）。在第3组中，患儿在120分钟时的临床反应优于其他两组（p<0.05）。未观察到任何治疗有显著不良反应。总之，对于急性中度哮喘患儿，累积剂量为90微克/千克的沙丁胺醇加累积剂量为1500微克的氟替卡松雾化治疗在2小时后能产生更好的临床缓解效果。然而，单独使用沙丁胺醇或联合不同剂量氟替卡松时，观察到的PEF和SaO₂反应相似。
