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吸入性糖皮质激素在激素依赖型难治性哮喘中的应用——吸入性糖皮质激素与口服糖皮质激素的等效剂量

[Usefulness of inhaled steroids in steroid-dependent intractable asthma--equivalent dose of oral steroid to inhaled steroid].

作者信息

Takahashi K, Kotoh N, Soda R, Tada S, Tanizaki Y, Kimura I

机构信息

Department of Internal Medicine, National Sanatorium Minami Okayama Hospital.

出版信息

Arerugi. 1994 Sep;43(9):1163-71.

PMID:7802600
Abstract

Twenty-four steroid-dependent intractable asthmatics were treated with oral prednisolone (PSL) (basic dose) + additional PSL and oral PSL (basic dose) + inhaled beclomethasone (BDP) alternately, to assess the clinical symptoms in each administration period. Equivalent doses of PSL to BDP were calculated. 1. Peak expiratory flow rate (PEF) during additional administration of BDP was markedly higher both in the morning and at night compared with that during additional administration of BDP was markedly higher both in the morning and at night compared with that during additional administration of PSL (p < 0.01 and p < 0.05 respectively). 2. The relation between additional doses of either PSL or BDP and attack scores was analysed in regression to obtain a dose equivalence line. 3. BDP 400 micrograms was equivalent to PSL 7.04 mg on average. 4. The equivalent dose of PSL to BDP tended to be lower in cases where the period of dependency on oral steroids was longer, the basic dose was larger, or the asthma was more severe. These data indicate that the application of inhaled steroids may be useful in the therapeutic management of steroid-dependent intractable asthmatics.

摘要

24例类固醇依赖型难治性哮喘患者分别接受口服泼尼松龙(PSL)(基础剂量)+额外PSL和口服PSL(基础剂量)+吸入倍氯米松(BDP)交替治疗,以评估每个给药期的临床症状。计算了与BDP等效的PSL剂量。1.与额外给予PSL时相比,额外给予BDP期间的最大呼气流量(PEF)在早晨和晚上均显著更高(分别为p<0.01和p<0.05)。2.分析PSL或BDP额外剂量与发作评分之间的关系并进行回归分析,以获得剂量等效线。3.BDP 400微克平均相当于PSL 7.04毫克。4.在口服类固醇依赖期更长、基础剂量更大或哮喘更严重的情况下,PSL与BDP的等效剂量往往更低。这些数据表明,吸入类固醇的应用可能有助于类固醇依赖型难治性哮喘的治疗管理。

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