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在“真实生活”环境中,用于控制哮喘的吸入性皮质类固醇不会影响青春期前儿童的线性生长速度。

Inhaled corticosteroids used for the control of asthma in a "real-life" setting do not affect linear growth velocity in prepubertal children.

机构信息

Children's Hospital Srebrnjak, Reference Center for Clinical Pediatric Allergy of the Ministry of Health, Zagreb, Croatia.

出版信息

Med Sci Monit. 2012 Sep;18(9):CR564-8. doi: 10.12659/msm.883352.

Abstract

BACKGROUND

Recent guidelines recommend inhaled corticosteroids as the first-line treatment for persistent asthma. However, long-term corticosteroid treatment in children has raised concerns about potential growth rate deceleration. We aimed to assess the association of growth velocity with the use of inhaled corticosteroids in prepubertal children with asthma in a "real-life" setting.

MATERIAL/METHODS: This study included 844 children aged 4-9.5 years coming to the hospital for regular check-ups between October 2006 and February 2009 for asthma with/without allergic rhinitis and no other known constraints of growth. Out of the 844 children, 790 had all data needed for analysis--245 children were not treated with ICS, 545 children received ICS (fluticasone, budesonide) with/without INCS (fluticasone, mometasone or budesonide). During the study period, 48 children with/without ICS received short SCS courses.

RESULTS

Mean (SE) height at the first check-up was 123.1 (0.31) cm; range (100.0-147.8 cm). Mean (SE) linear growth velocity (LGV) of the included children was 0.185 (0.0035) mm/day between 2 check-ups. No significant difference was found in LGV between the group not treated with ICS (0.180 mm/day±0.0055) and the group treated with ICS (0.187±0.0044 mm/day). Also, there was no statistical difference between subgroups according to additional therapy with INCS and SCS. No significant correlation was found for LGV and daily dose of ICS (r=0.086, p>0.05).

CONCLUSIONS

In our retrospective study using electronic hospital database, ICS and combined use of corticosteroids did not show any association with LGV in prepubertal asthmatic children in a "real-life" setting.

摘要

背景

最近的指南建议将吸入性皮质类固醇作为持续性哮喘的一线治疗药物。然而,儿童长期接受皮质类固醇治疗引起了对潜在生长速度减缓的担忧。我们旨在评估在“真实生活”环境中,吸入性皮质类固醇在患有哮喘的青春期前儿童中的生长速度与使用之间的相关性。

材料/方法:本研究纳入了 2006 年 10 月至 2009 年 2 月期间因哮喘(伴或不伴过敏性鼻炎)前来医院进行常规检查的 844 名 4-9.5 岁儿童,且无其他已知生长受限因素。在 844 名儿童中,790 名儿童具有分析所需的所有数据——245 名儿童未接受 ICS 治疗,545 名儿童接受 ICS(氟替卡松、布地奈德)联合/不联合 INCS(氟替卡松、莫米松或布地奈德)治疗。在研究期间,48 名接受 ICS 治疗的儿童接受了短期 SCS 治疗。

结果

首次就诊时的平均(SE)身高为 123.1(0.31)cm;范围(100.0-147.8 cm)。纳入儿童的平均(SE)线性生长速度(LGV)在两次就诊之间为 0.185(0.0035)mm/天。未接受 ICS 治疗的儿童组(0.180 mm/天±0.0055)和接受 ICS 治疗的儿童组(0.187±0.0044 mm/天)之间的 LGV 无显著差异。此外,根据额外的 INCS 和 SCS 治疗,亚组之间也没有统计学差异。LGV 与 ICS 的日剂量之间无显著相关性(r=0.086,p>0.05)。

结论

在我们使用电子医院数据库的回顾性研究中,ICS 和皮质类固醇联合使用在“真实生活”环境中并未显示与青春期前哮喘儿童的 LGV 有任何关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56ce/3560656/4231d821bc61/medscimonit-18-9-CR564-g001.jpg

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