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[在哮喘儿童长期丙酸倍氯米松治疗期间的促肾上腺皮质激素检测]

[Corticotropic testing during long-term beclomethasone dipropionate treatment in asthmatic children].

作者信息

Dutau G, Rochiccioli P

出版信息

Poumon Coeur. 1978;34(4):247-53.

PMID:693439
Abstract

The authors looked for undesirable side-effects in prolonged treatment with beclomethasone dipropionate aerosol (BDP) at the daily dose of 400 microgram in asthmatic children. Growth in height was not impaired, the height gain (5.35 +/- 4.06 cm) not being statistically different from the theoretical gain (5.46 +/- 2.94 cm) (t : 1.33 0.20 less than p less than 0.01). Testing the corticotropic chain at pituitary level by the L8VP test did not reveal any decrease in patients treated by BDP alone (delta of elevation of cortisolemia; 9.08 +/- 2.79 microgram/100 ml, not very different from the controls 9.79 +/- 4.32 microgram/100 ml). On the other hand, the results in patients with continuous or alternating conventional corticotherapy showed a corticotropic decrease (delta of elevation : 5.39 +/- 4.53 microgram/100 ml, a significant difference from the controls t : 7.54 p less than 0.001). In 5 of these observations, the repetition of L8VP testing revealed the progressive restauration of the corticotropic function together with the decrease and the stopping of conventional corticotherapy. The average cortisolemia of patients definitively off corticotherapy, before and after L8VP, was not significantly different from that of controls. The elevation delta of cortisolemia of deprived patients (9.30 +/- 4.92 microgram/100 ml) become comparable to that of normal controls (9.79 +/- 4.32 microgram/100 ml. The analysis of the main literature data, in agreement with the results presented here, showed that prolonged treatment with BDP had no harmful effect on height growth. There was no corticotropic decrease in a child unsubjected to previously conventional corticotherapy or after completely stopping the treatment.

摘要

作者们研究了哮喘儿童每日使用400微克丙酸倍氯米松气雾剂(BDP)进行长期治疗时的不良副作用。身高增长未受影响,身高增加量(5.35±4.06厘米)与理论增加量(5.46±2.94厘米)在统计学上无差异(t值:1.33,0.20<p<0.01)。通过L8VP试验检测垂体水平的促肾上腺皮质激素链,发现单独使用BDP治疗的患者未出现任何降低(皮质醇血症升高差值;9.08±2.79微克/100毫升,与对照组9.79±4.32微克/100毫升差异不大)。另一方面,接受持续或交替常规皮质激素治疗的患者结果显示促肾上腺皮质激素降低(升高差值:5.39±4.53微克/100毫升,与对照组有显著差异,t值:7.54,p<0.001)。在其中5例观察中,重复L8VP试验显示促肾上腺皮质激素功能逐渐恢复,同时常规皮质激素治疗减少并停止。完全停用皮质激素治疗的患者在L8VP前后的平均皮质醇血症与对照组无显著差异。停用皮质激素患者的皮质醇血症升高差值(9.30±4.92微克/100毫升)与正常对照组(9.79±4.32微克/100毫升)相当。对主要文献数据的分析与本文结果一致,表明BDP长期治疗对身高增长无有害影响。未接受过先前常规皮质激素治疗或完全停止治疗后的儿童未出现促肾上腺皮质激素降低。

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