Greenberg Richard A, Kerby Gwen, Roosevelt Genie E
Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah School of Medicine, Salt Lake City, Utah 84158, USA.
Clin Pediatr (Phila). 2008 Oct;47(8):817-23. doi: 10.1177/0009922808316988. Epub 2008 May 8.
The aim of this study was to determine if 2 doses of oral dexamethasone are as effective as a 5-day course of oral prednisone in preventing relapse for pediatric asthma exacerbations. Patients presenting to the emergency department with an asthma exacerbation were randomized to receive 0.6 mg/kg of dexamethasone or 2 mg/kg of prednisone in a prospective, double-blind study. The primary outcome was relapse within 10 days, and the secondary outcome was vomiting in the emergency department. Eighty-nine patients completed the study: 38 in the prednisone group and 51 in the dexamethasone group. In all, 3 patients in the prednisone group (8%) and 8 patients in the dexamethasone group (16%) required an unscheduled follow-up visit (P = .27). In all, 7 patients in the prednisone group (18%) and 5 patients in the dexamethasone group (10%) had vomiting ( P = .24). No difference was found in the relapse rate or incidence of vomiting between patients given prednisone and dexamethasone for pediatric asthma exacerbations.
本研究的目的是确定两剂口服地塞米松在预防小儿哮喘急性发作复发方面是否与为期5天的口服泼尼松疗程同样有效。在一项前瞻性双盲研究中，因哮喘急性发作到急诊科就诊的患者被随机分配接受0.6mg/kg地塞米松或2mg/kg泼尼松。主要结局是10天内复发，次要结局是在急诊科出现呕吐。89名患者完成了研究：泼尼松组38名，地塞米松组51名。总体而言，泼尼松组3名患者（8%）和地塞米松组8名患者（16%）需要进行非计划的随访（P = 0.27）。总体而言，泼尼松组7名患者（18%）和地塞米松组5名患者（10%）出现呕吐（P = 0.24）。在给予泼尼松和地塞米松治疗小儿哮喘急性发作的患者中，复发率或呕吐发生率未发现差异。
