吸入皮质类固醇对哮喘患者肾上腺皮质功能的影响

目的：了解吸入皮质类固醇对支气管哮喘患者肾上腺皮质功能的影响。方法：应用放射免疫测定法检测１５例正常人及３２例哮喘患者的晨血皮质醇浓度，并检测１５例和１７例哮喘患者分别在静注地塞米松５ｍｇ／ｄ２周及吸入二丙酸氯地米松（ＢＤＰ）干粉剂必酮碟８００μｇ／ｄ８周后的晨血皮质醇浓度。结果：哮喘患者晨血皮质醇浓度与正常人差异不明显（Ｐ〉０．０５），地塞米松组较治疗前明显下降（Ｐ〈０．００１），ＢＤＰ组虽也明显下降（Ｐ〈０．０５），但仍高于地塞米松组（Ｐ〈０．０１）。结论：全身使用皮质类固醇可引起哮喘患者肾上腺皮质的严重抑制，而吸入皮质类固醇也可对肾上腺皮质产生一定抑制作用。

The effect of inhaled corticosteroids on adrenocortical function in patients with asthma

Objective:To investigate the effect of inhaled corticosteroids on adrenocortical function in patients with asthma.Methods:The morning cortisol concentration was measured by radioimmunoassay in 15 healthy subjects and 32 asthmatics,among whom had taken dexamethasone intravenously for 2 weeks and 17 had taken Beclomethason Dipropionate dry powder for 8 weeks.Results:There was no significant difference in the morning cortisol concentration between the healthy subjects and asthmatics. The cortisol concentration in those taking dexamethasone decreased significantly(P<0.001), and so did those taking Beclomethason Dipropionate dry powder(P<0.05). But the latter was significantly higher than the former.Conclusion:Systemic corticosteroids may induce severe adrenal suppression and inhaled corticosteroids may also induce adrenal supperssion to some extent.