硫酸镁治疗儿童急性哮喘的疗效。
Efficacy of Magnesium Sulfate Treatment in Children with Acute Asthma.
机构信息
Pediatric Pulmonary Section, Department of Pediatrics, Mersin City Training and Research Hospital, Mersin, Turkey,
Pediatric Allergy Section, Department of Pediatrics, University of Cukurova, Adana, Turkey.
出版信息
Med Princ Pract. 2020;29(3):292-298. doi: 10.1159/000506595. Epub 2020 Feb 19.
OBJECTIVE
Systemic administration of magnesium sulfate (MgSO4) has been proposed as a treatment for pediatric patients with acute asthma. However, previous trials show mixed results and uncertain evidence of benefit. The aim of the study was to ascertain whether intravenous (IV) MgSO4 improves lung function parameters in children with acute asthma.
METHODS
This was a prospective clinical trial. All patients with acute asthma received 40-50 mg/kg or maximum 1,500 mg (>30 kg) of single dose IV MgSO4, administered over 60 min. Spirometry was conducted before and 15 min after MgSO4 infusion.
RESULTS
One hundred and fifteen children aged 6 to 17 years presenting with acute asthma and FEV1 between 40% and 75% of predicted were included. Then, the patients were classified into 2 groups; mild asthma attack (FEV1 ranged from 60% to 75%; n = 50) or moderate asthma attack (FEV1 ranged from 40% to 59%; n = 65). The baseline characteristics were similar in both groups. The mean percent predicted pre and post values for FEV1/FVC ratio (mild group: 82.59 ± 9.46 vs. 85.06 ± 8.95; moderate group: 77.31 ± 11.17 vs. 79.99 ± 11.77), FEV1 (mild group: 67.14 ± 4.99 vs. 72.29 ± 8.05; moderate group: 48.50 ± 6.81 vs. 53.78 ± 9.81), PEF (mild group: 65.49 ± 12.32 vs. 71.37 ± 12.96; moderate group: 47.56 ± 11.78 vs. 51.97 ± 13.98), and FEF25-75 (mild group: 58.20 ± 12.24 vs. 66.57 ± 16.95; moderate group: 37.77 ± 11.37 vs. 43.41 ± 14.19) showed a statistically significant (p < 0.05 for all) bronchodilator effect after MgSO4 infusion in both groups with few side effects.
CONCLUSION
Administration of IV MgSO4 was associated with improved pulmonary function in children with acute asthma.
目的
全身给予硫酸镁（MgSO4）已被提议作为治疗儿童急性哮喘的一种方法。然而，先前的试验结果显示出混合结果，并且对其益处的证据不确定。本研究的目的是确定静脉内（IV）MgSO4是否能改善急性哮喘患儿的肺功能参数。
方法
这是一项前瞻性临床试验。所有急性哮喘患儿均接受 40-50mg/kg 或最大 1500mg（>30kg）的单次 IV MgSO4 剂量，输注时间为 60min。在 MgSO4 输注前和输注后 15min 进行肺活量测定。
结果
115 名年龄在 6 至 17 岁之间、FEV1 在预测值的 40%至 75%之间的急性哮喘患儿入组。然后，将患者分为两组：轻度哮喘发作（FEV1 为 60%至 75%；n=50）或中度哮喘发作（FEV1 为 40%至 59%；n=65）。两组的基线特征相似。FEV1/FVC 比值的预值和后值的平均值（轻度组：82.59±9.46 vs. 85.06±8.95；中度组：77.31±11.17 vs. 79.99±11.77）、FEV1（轻度组：67.14±4.99 vs. 72.29±8.05；中度组：48.50±6.81 vs. 53.78±9.81）、PEF（轻度组：65.49±12.32 vs. 71.37±12.96；中度组：47.56±11.78 vs. 51.97±13.98）和 FEF25-75（轻度组：58.20±12.24 vs. 66.57±16.95；中度组：37.77±11.37 vs. 43.41±14.19）在两组中均显示出统计学上显著的（所有 p<0.05）支气管扩张作用，且副作用较少。
结论
静脉内给予 MgSO4 可改善急性哮喘患儿的肺功能。
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