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肾上腺皮质类固醇(皮质素)对支气管哮喘的治疗作用早已为人们所认识,但其用药时间稍长即可产生严重副作用。近二十年来发展起来的吸入疗法既可发挥皮质素独特的抗炎平喘功效,又可减少甚至避免全身副作用,颇受国内外学者的重视。目前已证明对哮喘有效的吸入皮质素有二丙酸倍氯米松(Beclomethasone dipropionate,BDP)、布地缩松(Budesonide,BUD)、氟尼缩松(Flunisolide,F)、曲安缩松(Triamcinolone acetonide,TA)和戊酸倍他米松(Betamethasone valerate,BV)。其中以BDP和BUD应用最为广泛。本文就皮质素吸入制剂(吸入皮质素)的体内代谢特点、作用机理、在儿童哮喘中的应用及可能发生的副作用作一综述。
The therapeutic effect of adrenal corticosteroids (corticosteroids) on bronchial asthma has long been known, but its longer medication can have serious side effects. Inhaled therapy developed in the past two decades can exert the unique anti-inflammatory and anti-asthmatic effect of cortisol and reduce or even avoid the systemic side effects, which are well received by scholars at home and abroad. Inhaled cortisone that has been shown to be effective against asthma has been identified as Beclomethasone dipropionate (BDP), Budesonide (BUD), Flunisolide (F), Triamcinolone acetonide , TA) and Betamethasone valerate (BV). Among them, BDP and BUD are the most widely used. In this paper, the metabolic characteristics of corticosteroid inhalation (inhaled corticosteroids) in vivo, the mechanism of action, the application in children with asthma and possible side effects are reviewed.