Wang Gang, Wang You-juan, Luo Feng-ming, Wang Lei, Jiang Li-li, Wang Lin, Mao Bing
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Acta Pharmacol Sin. 2006 Sep;27(9):1206-12. doi: 10.1111/j.1745-7254.2006.00418.x.
To investigate whether corticosteroids are effective in the treatment of plastic bronchitis with hemoptysis.
A retrospective, clinical study was undertaken. Thirty two patients with only first episodes of plastic bronchitis with hemoptysis were divided into a steroid group (n=18) treated with glucocorticoids, and a non-steroid group (n=14). The supportive therapy was uniformly applied to both groups, except for glucocorticoids. Variables such as temperature and white blood cell counts were determined. Furthermore, the volume of hemoptysis and bronchial casts were evaluated in detail daily.
There was no difference in the demographic data and variables at baseline between both groups (all P>0.05). On days 5, 6, 7 and 8, the volume of hemoptysis was significantly decreased in the steroid group compared with the non-steroid group (43+/-15 mL vs 117+/-33 mL on d 5, 29+/-12 mL vs 97+/-23 mL on d 6, 18+/-10 mL vs 80+/-20 mL on d 7, and 13+/-8 mL vs 66+/-14 mL on d 8; all P<0.05), and on d 10 after fibreoptic bronchoscopy, the cases with bronchial casts was reduced evidently in the steroid group in comparison with the non-steroid group (OR=5.69, 95% CI=1.76-43.6; P=0.005). There was no significance in mechanical ventilation and mortality between both groups.
Despite some limitations of this study, it has been demonstrated that, on the basis of common supportive therapy, corticosteroids would be effective and safe for the treatment of plastic bronchitis with hemoptysis.
探讨皮质类固醇激素对咯血型塑料支气管炎的治疗效果。
进行一项回顾性临床研究。32例首次发作的咯血型塑料支气管炎患者被分为类固醇组(n = 18),接受糖皮质激素治疗,和非类固醇组(n = 14)。除糖皮质激素外,两组均采用统一的支持治疗。测定体温和白细胞计数等变量。此外,每天详细评估咯血和支气管铸型的量。
两组在基线时的人口统计学数据和变量无差异(所有P>0.05)。在第5、6、7和8天,类固醇组的咯血血量与非类固醇组相比显著减少(第5天43±15 mL对117±33 mL,第6天29±12 mL对97±23 mL,第7天18±10 mL对80±20 mL,第8天13±8 mL对66±14 mL;所有P<0.05),在纤维支气管镜检查后第10天,类固醇组支气管铸型病例与非类固醇组相比明显减少(OR = 5.69,95%CI = 1.76 - 43.6;P = 0.005)。两组在机械通气和死亡率方面无显著差异。
尽管本研究存在一些局限性,但已证明,在常规支持治疗的基础上,皮质类固醇激素对咯血型塑料支气管炎的治疗是有效且安全的。