不同糖皮质激素类药物的长期吸入对支气管哮喘患儿骨代谢的影响-儿科学专业论文.docxVIP

万方数据 万方数据 目 录 中文摘要 ·············································································1 英文摘要 ·············································································4 英文缩写 ·············································································7 研究论文 不同糖皮质激素类药物的长期吸入对支气管哮喘患儿骨代 谢的影响 前言 ·············································································8 材料与方法 ····································································9 结果 ·············································································12 附表 ·············································································16 讨论 ·············································································18 结论 ·············································································25 参考文献 ·······································································26 综述 不同糖皮质激素类药物的长期吸入对支气管哮喘患儿骨代谢的 影响 ·········································································· 30 致谢 ···················································································36 个人简历 ·············································································37 中 中 文 摘 要 PAGE 10万方数据 PAGE 10 万方数据 不同糖皮质激素类药物的长期吸入对支气管 哮喘患儿骨代谢的影响 摘 要 目的：通过监测在哮喘治疗中长期应用不同的糖皮质激素辅舒酮（丙 酸氟替卡松吸入气雾剂）和布地奈德气雾剂的吸入疗法 6 个月对支气管哮 喘患儿身高生长速度、骨代谢指标（包括血清钙、血清磷、血清骨钙素 （BGP）和血清碱性磷酸酶（ALP）等指标）的影响，了解不同吸入式糖 皮质激素类药物的长期使用对支气管哮喘患儿骨代谢的影响。 方法：通过随机选取 2015 年 1 月至 2015 年 6 月在沧州市中心医院儿内科 病房住院及门诊就诊的 60 例年龄为 4.0~9.6 岁的支气管哮喘患儿作为治疗 组，其中男 33 例，女 27 例。将 60 例患儿随机分为 A 组、B 组，各 30 例。对治疗组患儿使用糖皮质激素吸入治疗，其中 A 组患儿给予辅舒酮 （丙酸氟替卡松吸入气雾剂），B 组患儿给予布地奈德气雾剂，两组患儿 确诊后均按照病情轻重采用空气压缩式雾化器给予不同剂量的气雾剂吸 入方案，吸入剂量均严格按照 GINA 方案执行：发作急性期婴儿 200μg， 每 8 小时一次；幼儿 400μg，每 8 小时一次。病情控制后根据年龄及严 重程度按照 GINA 阶梯方案减量，中度慢性缓解期婴儿 100μg，每十二 小时一次；幼儿 200μg，每 12 小时一次。重度慢性缓解期婴儿 200μg， 每 12 小时一次；幼儿 400μg，每 12 小时一次。哮喘控制后至少维持 3 个月再逐步降级治疗，两组患儿的治疗周期均为 6 个月。对患儿吸入治疗 前及吸入治疗后 6 个月的身高增长速度和骨代谢指标进行监测。同时随机 选取来医院健康体检的正常儿童 30 例作为对照组，对照组儿童进行常规 体检。 方法：治疗组 A 组、B 组与对照组的血清各项值的组间分析采用方 差分析，治疗组 A 组、B 组与对照组的身高生