Nikolaizik W H, Schöni M H
Alpine Children's Hospital, Davos Platz, Switzerland.
J Pediatr. 1996 Feb;128(2):271-4. doi: 10.1016/s0022-3476(96)70407-9.
To determine the effect of inhaled corticosteroids on lung function in patients with cystic fibrosis.
We report a pilot study of 49 patients with cystic fibrosis and moderate to severe bronchial obstruction (forced expiratory volume in 1 second < or = 55% of the predicted value); 25 patients were given inhaled corticosteroids for 30 days (1500 micrograms of beclomethasone via spacer), and 24 patients had the same standard treatment but no inhaled corticosteroids.
Forced vital capacity, forced expiratory volume in 1 second, and airway resistance showed significant improvement in both study groups, but thoracic gas volume and the diffusion capacity of the lung for carbon monoxide improved significantly only in the group given inhaled corticosteroids. When concomitant medications were taken into account, analysis of variance confirmed a significant effect of inhaled corticosteroids on the improvement of thoracic gas volume.
Inhaled corticosteroids in combination with standard treatment can contribute to the improvement of lung function in patients with cystic fibrosis and moderate to severe bronchial obstruction. Our preliminary data seem encouraging enough to warrant a multicenter, long-term, blind control study.
确定吸入性糖皮质激素对囊性纤维化患者肺功能的影响。
我们报告了一项针对49例囊性纤维化且伴有中度至重度支气管阻塞（一秒用力呼气容积≤预测值的55%）患者的初步研究；25例患者接受吸入性糖皮质激素治疗30天（通过储雾罐吸入1500微克倍氯米松），24例患者接受相同的标准治疗但未使用吸入性糖皮质激素。
两个研究组的用力肺活量、一秒用力呼气容积和气道阻力均有显著改善，但仅在接受吸入性糖皮质激素治疗的组中，肺总量和肺一氧化碳弥散量有显著改善。考虑到伴随用药情况，方差分析证实吸入性糖皮质激素对肺总量的改善有显著作用。
吸入性糖皮质激素联合标准治疗有助于改善囊性纤维化且伴有中度至重度支气管阻塞患者的肺功能。我们的初步数据似乎足够令人鼓舞，值得开展一项多中心、长期、盲法对照研究。
