口服泼尼松与吸入丙酸倍氯米松对循环白细胞影响的比较。

A comparison of the effects of oral prednisone and inhaled beclomethasone dipropionate on circulating leukocytes.

作者信息

Cameron R G, Black P N, Braan C, Browett P J

机构信息

University of Auckland, New Zealand.

出版信息

Aust N Z J Med. 1996 Dec;26(6):800-5. doi: 10.1111/j.1445-5994.1996.tb00628.x.

DOI:10.1111/j.1445-5994.1996.tb00628.x

PMID:9028511

Abstract

BACKGROUND

While the side effects of oral glucocorticoids are well recognised there is debate about the systemic effects of high doses of inhaled glucocorticoids such as beclomethasone dipropionate and how these compare with the effects of oral prednisone.

AIMS

To compare the effects of different doses of oral prednisone and inhaled beclomethasone dipropionate (BDP) on changes in circulating leukocytes.

METHODS

Changes in different subsets of circulating leukocytes were measured as an index of the systemic effects of inhaled BDP and oral prednisone. We compared the effects of inhaled placebo and 500 and 1000 micrograms of inhaled BDP with oral placebo and 2.5, 5 and 10 mg of prednisone in eight healthy volunteers. Leukocyte numbers were measured before and four hours after each dose of medicine.

RESULTS

Compared with inhaled placebo, 1000 micrograms of inhaled BDP led to a significant increase in neutrophils as a percentage of the total white count (p < 0.05) and a significant decrease in the total lymphocyte number (p < 0.05) and in the number of CD4 lymphocytes (p < 0.05). For 1000 micrograms BDP the increase in the % neutrophil count was 8.55% (95% CI 5.17 to 11.93) and the fall in lymphocyte numbers was -0.14 x 10(9)/L (95% CI 0.06 to -0.34) while 2.5 mg prednisone led to an increase in the % neutrophil count of 9.31% (95% CI 5.82 to 12.80) and a fall in lymphocyte numbers of -0.07 x 10(9)/L (95% CI 0.05 to -0.19).

CONCLUSIONS

The systemic effects of 1000 micrograms inhaled BDP and 2.5 mg of prednisone are similar.

摘要

背景

虽然口服糖皮质激素的副作用已广为人知，但对于高剂量吸入性糖皮质激素（如二丙酸倍氯米松）的全身效应以及这些效应与口服泼尼松的效应相比如何，仍存在争议。

目的

比较不同剂量的口服泼尼松和吸入二丙酸倍氯米松（BDP）对循环白细胞变化的影响。

方法

测量循环白细胞不同亚群的变化，作为吸入BDP和口服泼尼松全身效应的指标。我们在8名健康志愿者中比较了吸入安慰剂以及500微克和1000微克吸入BDP与口服安慰剂以及2.5毫克、5毫克和10毫克泼尼松的效果。在每次给药前和给药后4小时测量白细胞数量。

结果

与吸入安慰剂相比，1000微克吸入BDP导致中性粒细胞占总白细胞计数的百分比显著增加（p < 0.05），总淋巴细胞数量显著减少（p < 0.05），CD4淋巴细胞数量显著减少（p < 0.05）。对于1000微克BDP，中性粒细胞计数百分比的增加为8.55%（95%可信区间5.17至11.93），淋巴细胞数量的下降为-0.14×10⁹/L（95%可信区间0.06至-0.34），而2.5毫克泼尼松导致中性粒细胞计数百分比增加9.31%（95%可信区间5.82至12.80），淋巴细胞数量下降-0.07×10⁹/L（95%可信区间0.05至-0.19）。