Plomgaard A M, Schou A J, Wolthers O D
Children's Clinic Randers, Dytmaersken 9, 3, DK-8900 Randers, Denmark.
Ann Hum Biol. 2006 Mar-Apr;33(2):135-41. doi: 10.1080/03014460500466879.
Knemometry studies of growth suppressive effects of inhaled glucocorticoids in children with asthma usually allow participating children to use concomitant inhaled beta2-agonists. Systemic beta2-agonists, however, have been found to suppress growth hormone secretion and this has caused concern about a possible confounding effect of inhaled beta2-agonists on results of growth studies of exogenous glucocorticoids.
The study evaluated whether inhaled salbutamol adversely affects short-term growth.
Fifteen children aged 6-12 years with mild asthma were enrolled in a single-blind, randomized crossover study with two 2-week treatment periods and a 1-week run-in. During the active period treatment dry powder salbutamol (Ventoline Diskhaler) 200 microg was inhaled three times a day. During the comparative period no treatment was given. Knemometry of the right lower leg was performed on the first and the last day of each period.
Mean lower leg growth rates (SEM) during no-treatment and salbutamol periods were 0.35 (0.06) and 0.42 (0.07) mm per week, respectively (P = 0.35, t = -0.98, 95% CI: 0.25-0.93 mm per week).
Inhaled salbutamol 200 microg three times daily does not suppress short-term growth in asthmatic children. Inhaled beta2-agonists in equipotent doses and regimens can be safely used in short-term knemometric growth studies of exogenous glucocorticoids without any risk of confounding the results.
在哮喘儿童中,关于吸入糖皮质激素生长抑制作用的骨测量学研究通常允许参与研究的儿童同时使用吸入型β2激动剂。然而,已发现全身性β2激动剂会抑制生长激素分泌,这引发了人们对吸入型β2激动剂可能对外源性糖皮质激素生长研究结果产生混杂效应的担忧。
本研究评估吸入沙丁胺醇是否会对短期生长产生不利影响。
15名6至12岁的轻度哮喘儿童参与了一项单盲、随机交叉研究,该研究包括两个为期2周的治疗期和1周的导入期。在活性期治疗中,每天吸入3次200微克的干粉沙丁胺醇(万托林碟式吸入器)。在对照期不进行任何治疗。在每个时期的第一天和最后一天对右小腿进行骨测量。
在不治疗期和沙丁胺醇治疗期,小腿平均生长速率(标准误)分别为每周0.35(0.06)毫米和0.42(0.07)毫米(P = 0.35,t = -0.98,95%可信区间:每周0.25 - 0.93毫米)。
每日3次吸入200微克沙丁胺醇不会抑制哮喘儿童的短期生长。在对外源性糖皮质激素进行短期骨测量生长研究时,等量剂量和方案的吸入型β2激动剂可安全使用,不会有混淆结果的风险。