Katsunuma T, Tsubaki T, Ebisawa M, Sakaguchi N, Iikura Y, Mishima T, Kojima N, Matsuda S, Sugimoto H
National Children's Hospital, Ninomiya Branch Hospital.
Arerugi. 1994 Dec;43(12):1392-7.
The adrenal function of children with near fatal asthma was evaluated by a modified rapid ACTH test. The rapid ACTH tests, which were performed within six months of each life-threatening asthmatic episode, showed extremely low responsiveness. The response in the subjects was significantly lower than that of patients who had received high dose of corticosteroid therapy. It was suggested that the adrenocortical function of children with near fatal asthma had been already suppressed and that adrenal suppression could easily occur in such patients. We advocate the following measures: (1) environmental control, education of patients and their families, physical training accurate medication should be supplied to reduce the use of corticosteroids, (2) sufficient doses of corticosteroids should, however be given to patients with acute exacerbation, (3) not only lung function tests or allergic examinations, but also adrenocortical function tests should be performed on severe asthmatic patients.
通过改良快速促肾上腺皮质激素（ACTH）试验对濒死型哮喘患儿的肾上腺功能进行评估。在每次危及生命的哮喘发作后6个月内进行的快速ACTH试验显示反应性极低。研究对象的反应明显低于接受高剂量皮质类固醇治疗的患者。提示濒死型哮喘患儿的肾上腺皮质功能已受到抑制，且此类患者容易发生肾上腺抑制。我们提倡采取以下措施：（1）进行环境控制、对患者及其家属进行教育、开展体育锻炼并提供准确的药物治疗以减少皮质类固醇的使用；（2）然而，对于急性加重期患者应给予足够剂量的皮质类固醇；（3）对于重度哮喘患者，不仅应进行肺功能检查或过敏检查，还应进行肾上腺皮质功能检查。
