糖皮质激素治疗对细支气管炎患儿长期生长发育的影响。
Effect of glucocorticoid therapy on long-term growth and development of children with bronchiolitis.
作者信息
Aili Zha-Yidan, Abuduhaer Abulaiti
机构信息
Department of Pediatrics, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2022 Mar 15;24(3):261-265. doi: 10.7499/j.issn.1008-8830.2110071.
OBJECTIVES
To explore the effect of glucocorticoid therapy on the growth and development of children with bronchiolitis.
METHODS
A total of 143 children with bronchiolitis who were treated with glucocorticoids from February 2017 to March 2018 were enrolled. The medical data were retrospectively collected, including height, weight, course of the disease, and diagnosis and treatment plan at initial admission. After three years of treatment, physical development indices were measured, growth and development were evaluated by Z-score, and related hematological parameters were measured, including osteocalcin, serum phosphorus, and insulin-like growth factor-1.
RESULTS
As for the children with bronchiolitis, the incidence rates of growth retardation and obesity increased significantly after three years of glucocorticoid therapy (<0.05). The children treated with glucocorticoids for ≥29 days showed a significantly higher incidence rate of obesity than those treated with glucocorticoids for <29 days (<0.05), while nebulized glucocorticoid treatment had no effect on the growth and development (>0.05). Compared with the children with growth retardation, the children with normal development had significantly higher levels of serum phosphorus and insulin-like growth factor-1 (<0.05).
CONCLUSIONS
Glucocorticoid therapy can adversely affect long-term growth and development in children with bronchiolitis.
目的
探讨糖皮质激素治疗对小儿毛细支气管炎生长发育的影响。
方法
选取2017年2月至2018年3月间接受糖皮质激素治疗的143例毛细支气管炎患儿。回顾性收集其医学资料，包括身高、体重、病程以及初次入院时的诊断和治疗方案。治疗三年后，测量体格发育指标，采用Z评分评估生长发育情况，并检测相关血液学参数，包括骨钙素、血清磷和胰岛素样生长因子-1。
结果
对于毛细支气管炎患儿，糖皮质激素治疗三年后生长发育迟缓及肥胖的发生率显著增加（<0.05）。接受糖皮质激素治疗≥29天的患儿肥胖发生率显著高于治疗<29天的患儿（<0.05），而雾化吸入糖皮质激素治疗对生长发育无影响（>0.05）。与生长发育迟缓的患儿相比，发育正常的患儿血清磷和胰岛素样生长因子-1水平显著更高（<0.05）。
结论
糖皮质激素治疗可能对小儿毛细支气管炎的长期生长发育产生不利影响。
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