Brunette M G, Lands L, Thibodeau L P
Department of Pediatrics, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada.
Pediatrics. 1988 May;81(5):624-9.
In this study, the potential for short courses of glucocorticoids to prevent or reduce the severity of asthma induced by viral respiratory infections in preschool children was investigated. Two groups of children with a mean age of 36.4 +/- 3.9 months and 40.4 +/- 4.9 months were monitored during a 2-year period. Group 1, considered as the control group, received theophylline preparations and orciprenaline either on a continuous basis or during attacks. During severe attacks, albuterol was administered by nebulization, with corticosteroids occasionally added for seven to 14 days in cases of poor response to albuterol. Group 2 received the same treatment during the first year. During the second year, however, a short-term course of prednisone (1 mg/kg) was given as soon as the first symptoms of an upper respiratory tract infection appeared, prior to any signs of wheezing. Results indicate that, whereas morbidity remained constant in the control group during the 2-year observation period, a significant decrease in the number of wheezing days (65%), attacks (56%), visits to the emergency room (61%), and hospitalizations (90%) occurred in group 2. It was concluded that preschool children who suffer from repeated asthma attacks related to upper respiratory tract infections may benefit greatly from the preventive administration of corticosteroids.
在本研究中，调查了短期使用糖皮质激素预防或减轻学龄前儿童病毒性呼吸道感染诱发哮喘严重程度的可能性。在两年期间对两组平均年龄分别为36.4±3.9个月和40.4±4.9个月的儿童进行了监测。第1组被视为对照组，持续或在发作期间接受茶碱制剂和奥西那林治疗。在严重发作期间，通过雾化给予沙丁胺醇，对于对沙丁胺醇反应不佳的病例，偶尔加用糖皮质激素7至14天。第2组在第一年接受相同治疗。然而，在第二年，一旦出现上呼吸道感染的最初症状，在任何喘息迹象出现之前，即给予短期泼尼松疗程（1mg/kg）。结果表明，在两年观察期内，对照组的发病率保持不变，而第2组的喘息天数（65%）、发作次数（56%）、急诊就诊次数（61%）和住院次数（90%）均显著减少。得出的结论是，反复因上呼吸道感染而发作哮喘的学龄前儿童可能从预防性使用糖皮质激素中大大受益。
