Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Respir Med. 2010 Jul;104(7):951-6. doi: 10.1016/j.rmed.2010.02.002. Epub 2010 Feb 26.
Few studies on the concomitant effects of beclomethasone dipropionate and asthma-related factors on the growth of prepubertal asthmatic children have been published to date. In this prospective long-term 'real-life' cohort study we recruited 82 prepubertal steroid-naïve asthmatic patients aged 3 + years, excluding those with birth weight lower than 2500 g, malnutrition, and other concurrent chronic diseases. Height/age and weight/age Z scores were calculated every three months. Random effects multivariate longitudinal data analysis was used to adjust height/age and weight/age Z scores with independent variables. Among the studied patients, 63.4% were male, aged 4.7 + or - 1.5 years, 68.3% suffered from severe persistent asthma and had normal values for height/age and weight/age Z scores at enrolment. They were followed for 5.2 years (range 2.3-6.1) and used a mean daily beclomethasone dipropionate dose of 351.8 mcg (range 137.3-1140.0). Height/age and weight/age Z scores were not affected by either duration of treatment or doses of beclomethasone dipropionate up to 500 mcg, 750 mcg and higher than 750 mcg (p-values > 0.17). The multivariate analysis final model showed that severe persistent asthma was associated to lower height for age Z score (p = 0.04), whereas hospitalizations because of acute asthma (before and during follow-up) were associated (p = 0.02) to lower weight for age Z score. Growth parameters were not affected by the use of beclomethasone dipropionate.
目前为止,仅有少数研究探讨了丙酸倍氯米松与哮喘相关因素对青春前期哮喘患儿生长的共同影响。在这项前瞻性长期“真实生活”队列研究中,我们招募了 82 名 3 岁以上、未使用过类固醇的青春前期哮喘患儿,排除了出生体重低于 2500 克、营养不良和其他并存的慢性疾病患儿。每三个月计算一次身高/年龄和体重/年龄 Z 评分。采用随机效应多变量纵向数据分析,调整身高/年龄和体重/年龄 Z 评分与自变量的关系。在所研究的患者中,63.4%为男性,年龄为 4.7+1.5 岁,68.3%患有严重持续性哮喘,在入组时身高/年龄和体重/年龄 Z 评分正常。他们随访了 5.2 年(范围 2.3-6.1),平均每日丙酸倍氯米松剂量为 351.8 mcg(范围 137.3-1140.0)。身高/年龄和体重/年龄 Z 评分不受治疗持续时间或丙酸倍氯米松剂量的影响,直到剂量达到 500 mcg、750 mcg 和高于 750 mcg(p 值>0.17)。多变量分析最终模型显示,严重持续性哮喘与身高年龄 Z 评分较低有关(p=0.04),而因急性哮喘住院(随访前和随访期间)与体重年龄 Z 评分较低有关(p=0.02)。生长参数不受丙酸倍氯米松使用的影响。