Ciarallo L, Sauer A H, Shannon M W
Division of Emergency Medicine, Children's Hospital Boston, USA.
J Pediatr. 1996 Dec;129(6):809-14. doi: 10.1016/s0022-3476(96)70023-9.
To evaluate the efficacy of intravenous magnesium (IVMg) therapy for moderate to severe asthma exacerbations in pediatric patients.
Randomized, double-blind, placebo-controlled, clinical trial.
Urban pediatric emergency department.
Thirty-one patients aged 6 to 18 years who were being treated for an acute asthma exacerbation with peak expiratory flow rate (PEFR) less than 60% of the predicted value after receiving three beta 2-adrenergic nebulizer treatments.
Magnesium sulfate infusion, 25 mg/kg (maximum, 2 gm), or equivolume saline solution for 20 minutes.
Vital signs, O2 saturation by pulse oximetry, PEFR, forced vital capacity, forced expiratory volume at 1 second, and physical examination were serially recorded for 110 minutes, with serum magnesium concentrations measured before and after the 20-minute infusion. At 50 minutes the magnesium group had a significantly greater percentage of improvement from baseline in forced expiratory volume at 1 second (34% vs -1%; p = 0.05); this improvement was sustained and even greater at 110 minutes (75% vs 5%; p = 0.01). Results were similar for PEFR at 80 through 110 minutes (59% vs 20% at 110 minutes; p = 0.05) and for forced vital capacity (55% vs 8% at 80 minutes; p = 0.05). There were no significant intergroup differences in blood pressure at any point. Patients who received intravenous magnesium infusions were more likely to be discharged home from the emergency department than those who received placebo (4/15 vs 0/16; p = 0.03).
Children treated with intravenous magnesium infusions for moderate to severe asthma had significantly greater improvement in short-term pulmonary function without any significant alteration in blood pressure, suggesting a role for this agent as an adjunct in the treatment of such patients.
评估静脉注射镁剂（IVMg）治疗小儿中重度哮喘急性发作的疗效。
随机、双盲、安慰剂对照临床试验。
城市儿科急诊科。
31名年龄在6至18岁的患者，他们在接受三次β2肾上腺素能雾化治疗后，呼气峰值流速（PEFR）低于预测值的60%，正在接受急性哮喘发作治疗。
静脉输注硫酸镁，25mg/kg（最大剂量2g），或等体积生理盐水，持续20分钟。
连续记录110分钟的生命体征、脉搏血氧饱和度测定的血氧饱和度、PEFR、用力肺活量、第1秒用力呼气量和体格检查，并在20分钟输注前后测量血清镁浓度。在50分钟时，镁剂组第1秒用力呼气量较基线的改善百分比显著更高（34%对-1%；p=0.05）；这种改善持续存在，在110分钟时甚至更大（75%对5%；p=0.01）。在80至110分钟时，PEFR的结果相似（110分钟时为59%对20%；p=0.05），用力肺活量也是如此（80分钟时为55%对8%；p=0.05）。在任何时间点，两组血压均无显著差异。接受静脉注射镁剂的患者比接受安慰剂的患者更有可能从急诊科出院回家（4/15对0/16；p=0.03）。
静脉注射镁剂治疗中重度哮喘的儿童短期肺功能改善显著更大，且血压无任何显著变化，表明该药物可作为此类患者治疗的辅助药物。
