根据哪些参数,在患有喘的儿童中安全停止吸入性皮质类固醇的治疗?
Iva Mihatov Štefanović1,2, Renata Vrsalović1
1Department of Pediatrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
概括
临床评估和肺功能测试有效指导吸入性皮质类固醇 (ICS) 停止在患有喘的儿童,即使是那些有持续性支气管过敏反应 (BHR). 由于可能出现症状复发,建议继续监测.
科学领域:
- 儿科肺病学 儿科肺病学
- 过敏和免疫学 过敏和免疫学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 儿童喘缓解尚未得到充分研究,许多患者保留了支气管过敏反应 (BHR).
- 确定在儿童喘中停止吸入性皮质类固醇 (ICS) 的最佳标准对于管理长期治疗至关重要.
研究的目的:
- 评估临床参数和肺功能测试作为停用喘儿童的ICS的预测指标.
- 评估甲胆挑战测试 (MCT) 在ICS戒断后识别持久性BHR中的作用.
主要方法:
- 40名喘儿童在症状控制,螺旋计和支气管扩展剂测试的基础上停止了ICS治疗.
- 甲胆挑战测试 (MCT) 进行了一年后停止治疗,以评估BHR.
- 在ICS退出后,监测临床状态和螺旋计量.
主要成果:
- 50%的患者显示MCT阳性,表明持续的BHR.
- 在MCT阳性和MCT阴性组之间没有观察到肺功能 (FEV1,PEF) 或治疗史的显著差异.
- 在MCT阳性组中的两名患者由于复发症状需要重新启动ICS.
结论:
- 临床参数,正常的螺旋测量和负的支气管扩展剂测试是可靠的停用ICS在患有喘的儿童,即使在持久的BHR.
- 在停止ICS治疗后,对儿科喘患者进行持续监测至关重要,以检测潜在的症状复发.
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