Wolthers O D, Pedersen S
Department of Paediatrics, Kolding Hospital, Denmark.
Acta Paediatr. 1993 Aug;82(8):635-40. doi: 10.1111/j.1651-2227.1993.tb18030.x.
Short-term growth was studied during the grass pollen season with weekly knemometry in 44 schoolchildren with allergic rhinitis. The design was a randomized, parallel group study. After a four-weeks run-in period, the children were allocated to six weeks' treatment with either a single im injection of methylprednisolone acetate 60 mg at the beginning of the period, intranasal budesonide 200 micrograms bid (aerosol spray) or terfenadine tablets 60 mg daily. Treatment with methylprednisolone acetate was open, whereas treatment with budesonide and terfenadine was double-blinded. Twelve children in the methylprednisolone acetate group, 11 in the budesonide group and 12 in the terfenadine group completed the study. Compared with the run-in period, treatment with methylprednisolone acetate and budesonide (run-in growth velocities 0.46 and 0.59 mm/week, respectively) was associated with a reduction in mean lower leg growth velocity of 0.28 and 0.54 mm/week (p < 0.01, t = 3.3, 95% confidence interval 0.09-0.47 mm/week; and p < 0.001, t = 6.1, 95% confidence interval 0.34-0.72 mm/week, respectively). Terfenadine (run-in and treatment mean growth velocity 0.35 and 0.51 mm/week) did not influence lower leg growth significantly. Short-term lower leg growth is suppressed in children with allergic rhinitis treated with intranasal and depot steroids in the doses investigated. No conclusions can be drawn with respect to long-term statural growth.
在草花粉季节,对44名过敏性鼻炎学童进行每周小腿测量,研究短期生长情况。该设计为随机平行组研究。经过四周的导入期后,将儿童分为三组,分别接受为期六周的治疗:一组在治疗开始时单次肌肉注射60毫克醋酸甲泼尼龙;一组每日两次鼻内使用200微克布地奈德(气雾剂喷雾);一组每日服用60毫克特非那定片。醋酸甲泼尼龙的治疗为开放治疗,而布地奈德和特非那定的治疗为双盲治疗。醋酸甲泼尼龙组12名儿童、布地奈德组11名儿童和特非那定组12名儿童完成了研究。与导入期相比,醋酸甲泼尼龙和布地奈德治疗(导入期小腿生长速度分别为0.46和0.59毫米/周)使小腿平均生长速度分别降低了0.28和0.54毫米/周(p<0.01,t=3.3,95%置信区间0.09 - 0.47毫米/周;以及p<0.001,t=6.1,95%置信区间0.34 - 0.72毫米/周)。特非那定(导入期和治疗期平均生长速度为0.35和0.51毫米/周)对小腿生长无显著影响。在所研究的剂量下,鼻内和长效类固醇治疗的过敏性鼻炎儿童的小腿短期生长受到抑制。关于长期身高生长,无法得出结论。