甲基强的松龙等激素治疗儿童哮喘持续状态的对照研究

目的:评价全身用皮质类固醇(甲基强的松龙、氢化考的松及地塞米松)治疗哮喘持续状态的效果。方法:99例哮喘持续状态患儿分成三组:甲基强的松龙治疗组(甲强组)28例,氢化考的松治疗组(氢考组)32例,地塞米松治疗组(地米组)39例。监测哮鸣音消失时间、治疗前及72h后PEFR、住院天数及费用。采用χ2检验及方差分析、SNK法进行统计学分析。结果:(1)三组患儿哮鸣音消失时间的差异有统计学意义(F=8.247,P=0.001),甲强组与地米组之间、氢考组与地米组之间P均<0.05,但甲强组与氢考组之间P=0.649。(2)三组患儿治疗前PEFR的差异无统计学意义(F=0.495,P=0.612);三组患儿治疗72h后PEFR的差异有统计学意义(F=6.073,P=0.04),甲强组与地米组之间、氢考组与地米组之间P均<0.05,但甲强组与氢考组之间P=0.931。(3)三组患儿住院天数(F=3.052,P=0.052)及费用(F=0.675,P=0.511)的差异无统计学意义。结论:治疗哮喘持续状态首选甲基强的松龙,起效快、效果好、副作用少。

Clinical comparison study of methylprednisolone in treating status athmaticus of children

Objective: To compare the effects on status athmaticus of children tr eated with methylprednisolone, hydrocortisone and dexamethasone. Methods: In a t rial, 99 children with status athmaticus were divided into three groups: methylp rednisolone group (n=28), hydrocortisone group (n=32), dexamethasone group (n=39 ). The time of wheezing vanishing, PEFR before treatment and 72 hr after, the da ys and costs of hospitalization were recorded. Results were analyzed with chi-sq uare test, analysis of variance and Student-Neuman-Keuls. Results: (1) There was statistically significant difference among the groups in the time of wheezing v anishing (F =8.247, P=0.000), but there was no statistically significant differe nce between methylprednisolone group and hydrocortisone group (P=0.649). (2) The re was no statistically significant difference among the groups in PEFR before t reatment (F =0.495, P=0.612). There was statistically significant difference amo ng the groups in PEFR 72 hr after(F =6.073, P=0.04), but there was no statistica lly significant difference between methylprednisolone group and hydrocortisone g roup (P=0.931).(3)There was no statistically significant difference among the gr oups in the days (F =3.052, P=0.052) and costs (F =0.675, P=0.511) of hospitaliz ation. Conclusion: Methylprednisolone, which can be used as the preferred cortic osteroids, was significantly effective with less side-effect in treating status athmaticus of children.