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在急性喘中逐渐减少类固醇的双盲试验
B R O'Driscoll1, S Kalra, M Wilson
1North West Lung Centre, Wythenshawe Hospital, Manchester, UK.
在急性喘恶化后,不需要减少口服类固醇. 一项随机研究发现,在逐渐减少或突然停止使用普得尼索隆的患者之间,肺功能或症状没有显著差异. 这表明替代性喘管理计划可能更适合.
科学领域:
- 肺部病理学 肺部病理学
- 临床医学 临床医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 口服类固醇逐渐减少是急性喘恶化后的标准做法,以防止反弹喘.
- 在住院急性喘患者中逐渐减少口服普雷迪尼索隆的临床益处尚不清楚.
研究的目的:
- 为了调查口服普雷尼索隆的逐渐循环是否在急性喘住院的患者中比突然终止的循环提供优势.
主要方法:
- 一项随机,双盲研究,涉及35名住院急性喘患者.
- 患者每天接受10天的40毫克肠膜涂层普雷迪尼索隆,随后进行8天的活跃逐渐减少疗程或安慰剂逐渐减少疗程.
- 主要结果指标是醒来时的最大呼气流量 (PEFR).
主要成果:
- 两组在第10天表现出良好的反应,平均上午PEFR相似 (活性逐渐减少:396 L/min,安慰剂逐渐减少:391 L/min).
- 在逐渐减少和突然戒断组之间没有观察到PEFR,症状得分或治疗失败的显著差异.
- 二级结局,包括症状评分和支气管扩展剂治疗后的PEFR,也没有显示群体之间的显著差异.
结论:
- 在急性喘恶化需要住院治疗时,降低类固醇似乎是不必要的.
- 个性化的喘管理计划,包括口服普雷迪尼索隆的储备疗程,可能是比例行逐渐减少更合适的策略.
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