呼吸系统症状儿童的皮质类固醇处方:一个现实生活研究
Remedios Cárdenas Contreras1,2, Alicia Habernau Mena3, Elisa Haroun Díaz4
1Virgen del Rocío University Hospital, Seville, Spain.
Allergologia et immunopathologia
|May 9, 2025
概括
许多患有喘的儿童过度使用口服皮质类固醇治疗恶化,而不是吸入皮质类固醇. 这导致频繁的急诊并影响生活质量,强调需要更好的喘管理策略.
科学领域:
- 儿科过敏和免疫学
- 呼吸系统医学 呼吸系统医学
- 临床儿科 临床儿科
背景情况:
- 喘是一种普遍的儿童疾病,大多数儿童对标准治疗有反应.
- 一部分儿科喘患者尽管接受了初始治疗,但仍然表现出症状,需要进行先进的治疗.
- 目前的恶化管理往往依赖于短效β-激动剂和口服皮质类固醇,经常忽略了像吸入性皮质类固醇这样的必要的维持疗法.
研究的目的:
- 调查系统性皮质类固醇 (SC) 对12岁以下儿童呼吸道恶化症的使用情况.
- 在初始儿科过敏咨询之前,评估维持治疗处方的差距,特别是吸入性皮质类固醇 (ICS) 和抗白类固醇.
主要方法:
- 一个描述性的,回顾性的,观察性的,多中心的研究.
- 数据来自144名12岁以下的儿童,他们参加了第一次儿科过敏咨询.
- 分析的重点是系统性皮质类固醇使用和在咨询前一年处方的维持疗法.
主要成果:
- 70%的儿童经历了多年性喘症状,但只在需求时处方SABA,缺乏ICS或抗白三烯.
- 儿童平均每年三次访问急诊室,因为恶化.
- 近75%的患者在恶化期间接受了全身性皮质类固醇 (普雷尼索隆),超过一半的患者平均每年接受2.6个周期,通常在急诊室处方.
结论:
- 在有呼吸道症状的亚托皮儿童中,观察到系统性皮质类固醇的过度使用.
- 不足够的维持疗法,特别是ICS的缺失,导致频繁的恶化和SC过度使用.
- 临床实践转向一致的ICS使用对于预防恶化和改善儿科喘患者的生活质量至关重要.
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