【doc】阿奇霉素对哮喘儿童支气管高反应性的影响.doc

阿奇霉素对哮喘儿童支气管高反应性的影响 ? 208? ? 论着? 丝翌鲎盎蠢丛堡生箜2卷第3 阿奇霉素对哮喘儿童支气管高反应性的影响 刘冬云刘长山杨静 【摘要】目的探讨阿奇霉素对轻,中度哮喘儿童支气管高反应性(BI-IR)的影响.方法轻,中度哮喘儿童36例,用布 地奈德吸入(剂量为轻度哮喘lO0~g/d,中度哮喘200p.g/d)4周后,分为A,B两组,进入试验观察.所有病例继续应用布地奈德 吸入,剂量同前,A组21例,年龄(9.40~3.04)岁,加用阿奇霉素口服,剂量为每日7.5mg/kg,最大剂~lt;250,w/d,每周2次.B 组15例,年龄(9.19±3.04)岁.试验期为8周.两组在试验开始和结束时检测PEF,F]E=,,l及组胺激发的使FEV】下降20%的 组胺量(PD2o—FEV1),并评定8周试验期内的有症状天数.结果A组治疗后PD20一FEVl较治疗前有明显升高,而PEF,FEV 和有症状天数未见改善.结论用小剂量阿奇霉素13服8周,并联合吸入型皮质激素治疗,轻,中度哮喘儿童的BHR明显降 低;而PEF,FEV和有症状天数未见改善. 关键词哮喘儿童大环内酯类抗生素支气管高反应性 【文献标识码】A【文章编号】1681—5459{2005)03—0208—03 Effectofazithromycinonseverityofbronchialhyperresponsivenessin childrenwithasthma LiuDongyun,厶ⅡChangshan,ynngJing DepartmentofPediatrics,FirstHospital,Tianjin300010. 【Al~raet】ObjectiveToobservetheeffectofazithromycinonbronchialhyperresponsivenessinchildrenth mildandmoderateasthma.MethodsAftertmdergoingtreatmentthbudesonideatdosesoflO0/_~d～200p.g/dfor fourweeks,36casesofmildandmoderateasthmaweredividedintotwogroups.Allchildrenwithasthlnaintwogroups continuedthetreatmentofbudesonide.GroupAwas21cases(13males/9females,aged9.40±3.04yrs),treatedorally withazithromycinatadoseof7.5mg/kgdaily(maximum250mgdaily),itwasadministeredintermittentlytwiceaweek. GroupBWas15cases(9males/6females,aged9.19±3.04yrs).1heperiodoftreatmentWaseightweeks.PEF,FEV1 andPD20一FEVl(theprovocativedoseofhistaminecausinga20%fallinFEV1)weremeasuredatthebeginningandthe endoftreatmentperiod.Symptomaticdayswithineightweekswereevaluatedattheendoftreatmentperiod.Results PEI20一FEVlmeanvaluesofgroupAincreasedsignificantlyattheeighthweekafteradministrationofazithromycinbut symptomaticdaysandmeanvaluesforPEFandFEV1didnotdiffersignificantly.ConclusionThetreatmentofinhaled corticostemidscombinedlow—doseadministrationofazithromycinforeightweeksinchildrenwithmildandmoderate asthlDacouldreduceseverityofbronchialhyperresponsiveness. Keywordsasthmachildrenmacmlideantibioticsbronchialhyperresponsiveness 哮喘是一种气道慢性炎症性疾病,支气管高反 应性(BHR)是哮喘的重要特征.近年来,人们发现 14环,15环的大环内酯类抗生素对哮喘和气道慢性 炎症有一定治疗