Hoffman I B, Fiel S B
Pulmonary Disease Section, Temple University Hospital, Philadelphia.
Chest. 1988 Jan;93(1):11-3. doi: 10.1378/chest.93.1.11.
Acutely ill asthmatic patients treated in the usual fashion in an emergency room setting and discharged within six hours were studied to determine whether therapy with a single injection of a repository corticosteroid (methylprednisolone sodium acetate) could be as effective as a tapering course of oral corticosteroids in decreasing asthma symptomatology and relapse within seven days. Seventeen patients (18 episodes of asthma) formed the study population. Eight episodes occurred in patients who received depot methylprednisolone (group 1) and ten episodes in patients who received oral corticosteroid treatment (group 2). All patients in both groups improved following emergency room treatment. Relapse occurred in two of ten patients in group 2 and none in group 1. Symptoms attributable to asthma recurred in significantly more patients in group 2 than in group 1 (9 vs 0, p less than .01). Side effects from therapy with corticosteroids were rare. This study indicates that intramuscular repository corticosteroids are at least as effective as oral corticosteroids in the management of the acute asthmatic outpatient, with a distinct advantage with regard to patient compliance.
对在急诊室以常规方式治疗并在6小时内出院的急性哮喘患者进行了研究，以确定单次注射长效糖皮质激素（醋酸甲泼尼龙）治疗在减轻哮喘症状和7天内复发方面是否与口服糖皮质激素逐渐减量疗程一样有效。17名患者（18次哮喘发作）构成了研究人群。8次发作发生在接受长效甲泼尼龙的患者中（第1组），10次发作发生在接受口服糖皮质激素治疗的患者中（第2组）。两组所有患者在急诊室治疗后均有改善。第2组10名患者中有2名复发，第1组无复发。第2组中因哮喘复发的症状明显多于第1组（9例对0例，p<0.01）。糖皮质激素治疗的副作用很少见。这项研究表明，在急性哮喘门诊患者的管理中，肌肉注射长效糖皮质激素至少与口服糖皮质激素一样有效，在患者依从性方面具有明显优势。
