摘要
吸入性类固醇常用于儿童哮喘治疗,但基于有限客观证据的长期副作用仍令人担忧。本研究评估了标准剂量吸入类固醇治疗儿童哮喘的全身效应,比较了二丙酸倍氯米松(BDP)和丙酸氟替卡松(FP)。该研究为前瞻性、随机和双盲研究。23名年龄5-10岁的未使用类固醇的中度严重哮喘儿童,使用带间隔的计量吸入器,分配BDP(400微克x天(-1)或FP(200微克x天(-1))。在20个月内定期评估哮喘控制情况。采集空腹晨血和夜间尿样,测定血清皮质醇、血清1-羧基末端肽(ICTP)、血清骨钙素和尿脱氧吡啶啉(DPD)。每次就诊均测量骨密度(BMD)。在研究期间,没有任何骨转换的标记物显示出任何变化。骨密度随年龄增长以正常速度增加。BDP组血清皮质醇显著降低,FP组无显著差异。 A significant difference in growth rates was found between the groups, with a slower rate of growth towards the end of the observation period in the BDP group. In conclusion when taken in a relatively modest dose over a period of time, beclomethasone dipropionate had significant effects on the hypothalamic-pituitary-adrenal axis and statural growth in childhood asthma. These systemic effects were not seen with an equipotent dose of fluticasone propionate.