Aoyagi Masahiko, Kojima Hiroyuki, Sato Kazuki, Watanabe Hiroko, Sekine Kunio, Nishimuta Toshiyuki
Department of Pediatrics, National Shimoshizu Hospital, Japan.
Arerugi. 2005 Oct;54(10):1190-6.
The efficacy of systemic corticosteroids for infants and toddlers with acute severe asthma has been inadequately evaluated.
The purpose of this study was to evaluate the additive efficacy of intravenous prednisolone in a randomized controlled study in the management of infants and toddlers with acute severe asthma.
Sixty-two patients (aged 8 to 70 months) hospitalized with status asthmaticus were studied. They were randomized into two groups. One group received intravenous prednisolone treatment (1 approximately 3 mg/kg/day, 3 days); the other group served as a control. Each group received continuous aminophylline infusion and low-dose continuous isoproterenol inhalation by an Inspiron nebulizer. They were monitored their heart rate, respiratory rate and symptoms (Wood's clinical score).
Each group showed rapid improvement in heart rate, respiratory rate and clinical score by low-dose continuous isoproterenol inhalation. There were no significant differences in the time course of these clinical indexes or the duration of aminophylline infusion, continuous isoproterenol inhalation and hospital stay.
This study failed to confirm the additive benefit of intravenous prednisolone in the management of infants and toddlers with acute severe asthma.
全身用皮质类固醇对婴幼儿急性重症哮喘的疗效尚未得到充分评估。
本研究旨在通过一项随机对照研究评估静脉注射泼尼松龙在婴幼儿急性重症哮喘治疗中的附加疗效。
对62例因哮喘持续状态住院的患者（年龄8至70个月）进行研究。他们被随机分为两组。一组接受静脉注射泼尼松龙治疗（1至3毫克/千克/天，共3天）；另一组作为对照。每组均接受氨茶碱持续静脉输注以及通过英斯派隆雾化器进行低剂量异丙肾上腺素持续吸入治疗。监测他们的心率、呼吸频率及症状（伍德临床评分）。
通过低剂量异丙肾上腺素持续吸入，每组的心率、呼吸频率及临床评分均迅速改善。这些临床指标的时间进程、氨茶碱静脉输注时间、异丙肾上腺素持续吸入时间及住院时间均无显著差异。
本研究未能证实静脉注射泼尼松龙在婴幼儿急性重症哮喘治疗中的附加益处。
