咳嗽变异性哮喘吸入布地奈德后血清皮质醇及血糖变化.doc

咳嗽变异性哮喘吸入布地奈德后血清皮质醇及血糖变化[摘要] 目的：探讨吸入低剂量布地奈德治疗对咳嗽变异性哮喘（CVA）患者血清皮质醇和血糖的影响，评价吸入激素治疗的安全性。方法：选取CVA患者25例，检测每日吸入400 μg布地奈德，观察治疗3个月前后血清皮质醇及血糖、糖化血红蛋白浓度，并加以对比。以健康体检者21名为对照。结果：吸入布地奈德治疗前后两组血清皮质醇及血糖、糖化血红蛋白浓度比较，差异无统计学意义（P＞0.05）。结论：低剂量吸入布地奈德治疗咳嗽变异性哮喘安全有效，对患者的血清皮质醇、血糖无明显影响。 [关键词] 咳嗽变异性哮喘；布地奈德；皮质醇；糖化血红蛋白 [中图分类号] R256.25[文献标识码]B [文章编号]1674-4721（2011）02（b）-057-02 The changes of serum cortisol and blood glucose in cough variant asthma after inhaling budesonide HAN Kai1, ZHU Xiaoji2*, YANG Hua2, ZHANG Keli2, LI Ning2 (1.Weifang Medical University, Shandong Province, Weifang 261042, China; 2. Department of Respiratory Medicine, the 89th Hospital of PLA, Shandong Province, Weifang 261021, China) [Abstract] Objective: To investigate the changes of serum cortisol and blood glucose in cough variant asthma (CVA) patients after inhaling low-dose budesonide and evaluate the safety of inhaling cortieosterolds. Methods: 25 CVA cases were covered. The concentrations of serum cortisol, blood glucose and glycosylated hemoglobin were detected at 8 o′clock in the morning before and after three-month daily inhaling 400 μg budesonide. 21 healthy men were chosen at the same time as the normal controls. Results: There was no significant difference (P0.05) between the serum cortisol, blood glucose and glycosylated hemoglobin before and after the inhalation of budesonide in CVA patients. Conclusion: Inhalation of low-dose budesonide is safe and effective for the treatment of cough variant asthma, and there is no obvious changes found in serum cortisol, blood glucose and glycosylated hemoglobin. [Key words] Cough variant asthma; Budesonide; Cortisol; HbA1c 近年来，国内外多项研究发现，咳嗽变异性哮喘（cough variant asthma，CVA）是成人慢性咳嗽的最常见的病因之一，占10%~50%[1]。2010年我国首个多中心慢性咳嗽病因调查结果显示，CVA是我国慢性咳嗽的首位病因[2]。因其本质与典型哮喘一样均为气道的慢性炎症，故治疗首选吸入糖皮质激素。由于过分担心激素的副作用，部分患者拒绝使用激素治疗或过早停药，致使治疗依从性下降，从而不能达到病情控制，甚至发展成为典型哮喘。本研究旨在观察吸入低剂量布地奈德治疗对咳嗽变异性哮喘患者血清皮质醇及血糖的影响，为安全使用激素、提高患者治疗的依从性提供客观依据。 1 资料与方法 1.1 一般资料 咳嗽变异性哮喘患者30例，均为男性，因患者原因（依