在轻度至中度过敏反应后对皮质类固醇进行随机盲试验,以防止复发
Rafah Al Sayyed1, Khalid Alansari2,3,4
1Department of Pediatric Medicine, Hamad Medical Corporation, Doha, Qatar.
Medicine
|August 5, 2025
概括
对于在过敏反应后从急诊室出院的儿童,不建议常规使用皮质类固醇. 这项研究发现,与安慰剂相比,使用德甲没有显著减少复发.
科学领域:
- 儿科急救医学 儿科急救医学
- 过敏和免疫学 过敏和免疫学
- 临床药理学 临床药理学
背景情况:
- 皮质类固醇可能会缩短对过敏反应的住院时间,但对急诊室 (ED) 出院的儿童的益处尚不清楚.
- 常规使用皮质类固醇会带来潜在的不良影响.
研究的目的:
- 为了确定是否排泄前口服德克萨米他可以减少ED治疗儿童的过敏反应复发.
- 评估德克萨米他与安慰剂在预防7天内过敏反应复发的疗效.
主要方法:
- 一项试点,盲目,随机试验,涉及3个月至14岁的儿童出现过敏反应.
- 参与者在ED出院前接受了口服德克萨梅他 (0.3毫克/千克,最大10毫克) 或同样的安慰剂.
主要成果:
- 由于COVID-19的原因,招募工作被提前暂停;152名患者被随机分配 (68名德克萨米他,75名安慰剂).
- 复发率很低:德甲组的4.4%,而安慰剂组的6.7%.
- 绝对风险降低为2.3%,治疗所需数为44,P值为7.7.
结论:
- 不常见的复发率和需要治疗的高数量表明,常规的放出前皮质类固醇对ED治疗的过敏反应没有好处.
- 皮质类固醇的使用应保留给具有明确临床理由的病例.
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