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布地奈德:儿童期支气管哮喘的治疗

Budesonide: treatment of bronchial asthma during childhood.

作者信息

Eseverri J L, Botey J, Marin A M

机构信息

Department of Allergy and Paediatric Clinical Immunology. Vall d'Hebron maternity. Children's university hospital, Barcelona.

出版信息

Allerg Immunol (Paris). 1995 Apr;27(4):129-35.

PMID:7772248
Abstract

Nowadays inhaled corticosteroids are the first step in treating inflammation of the airways. It is evident that these drugs are not free of side effects; however, the fact that at present the most commonly used method is by inhalation and that these drugs undergo metabolic changes in the lung, makes them safe in that a part of the side effects, which are observed when they are administered systemically, disappear. Budesonide was one of the last corticosteroids for topical application to appear on the market and its powerful anti-inflammatory action together with in versatility (it can come in aerosol form using MDI or in solution for nebulizers as well as in dry powder) make it possible to use during all stages of a child's development. In 75 children treated with Budesonide over a long period (18-24 months) we were able to evaluate the drug's clinical efficacy in the reduction in number and intensity of attacks registered together with their accompanying symptoms. Significantly (p < 0.001) it were able to restrict the bronchodilatory medication needed to control their asthma. Similarly, we were able to verify that the FEV1 was normalized and that the Peack Flow was stabilized. We were not able to find any interruption in the hypothalamo-hypophysio-suprarenal axis and the weight-height curves continued to evolve chronologically. With regards to the side effects, three cases of colonization candidiasis were recorded through there were no clinical repercussions and treatment did not need to be suspended.

摘要

如今,吸入性糖皮质激素是治疗气道炎症的首选药物。显然,这些药物并非没有副作用;然而,目前最常用的给药方式是吸入,且这些药物在肺部会发生代谢变化,这使得它们具有安全性,因为部分全身给药时观察到的副作用会消失。布地奈德是最后一批上市的局部应用糖皮质激素之一,其强大的抗炎作用以及多功能性(它可以通过定量吸入器制成气雾剂形式,也可以制成雾化器溶液或干粉形式)使其能够在儿童发育的各个阶段使用。在75名长期(18 - 24个月)接受布地奈德治疗的儿童中,我们能够评估该药物在减少发作次数和强度以及伴随症状方面的临床疗效。显著地(p < 0.001),它能够减少控制哮喘所需的支气管扩张药物。同样,我们能够证实第一秒用力呼气容积(FEV1)恢复正常,呼气峰值流速(Peack Flow)趋于稳定。我们未发现下丘脑 - 垂体 - 肾上腺轴有任何中断情况,体重 - 身高曲线按时间顺序持续变化。关于副作用,记录到3例念珠菌定植病例,但无临床影响,治疗无需中断。

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