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吸入皮质激素(ICS)治疗重症哮喘的推荐剂量有全身性副反应,包括清晨血浆皮质醇降低和影响骨代谢。丙酸氟替卡松(FP)是一种新的ICS,比二丙酸氯地米松(BDP)等的局部抗炎作用更强,对支气管高反应性、FEV_1、峰呼气量(PEFR)和症状计分与双倍量BDP作用相当。最新研究表明,FP对下丘脑-垂体-肾上腺轴的影响比同等作用剂量的BDP更小。作者比较了FP750μg/d和BDP 1500μg/d各6周对成人哮喘患者骨代谢指标和血清皮质醇的影响。 对30例不吸烟的门诊哮喘患者进行随机、双盲、交叉试验。男性16例,女性14例,年龄18～55岁,6个月内未用过口服皮质激素。ICS治疗期间,患者吸入FP375μg或BDP 750μg,2次/d,分别用6周,间歇3周后交替。ICS治疗前后测定基础肺功能、FEV_1、PEFR;测定清晨血浆皮质醇含量及钙(Ca)、磷(P)、甲状旁腺激素(PTH)、1.25(OH)_2D_3;测定骨形成标志血清碱性磷
The recommended dose of inhaled corticosteroids (ICS) in the treatment of severe asthma is systemic side effects, including early morning plasma cortisol reduction and bone metabolism. Fluticasone propionate (FP) is a new ICS that is more potent anti-inflammatory than bupivacaine dipropionate (BDP) and has high sensitivity to bronchial hyperresponsiveness, FEV 1, peak expiratory volume (PEFR), and symptomatology Points and double the amount of BDP equivalent. Recent research shows that FP has a smaller effect on the hypothalamic-pituitary-adrenal axis than the equivalent dose of BDP. The authors compared the effects of FP750 μg / d and BDP 1500 μg / d for 6 weeks on bone metabolic parameters and serum cortisol in adults with asthma. Thirty patients with non-smoking outpatients with asthma were randomized, double-blind, and crossover trials. 16 males and 14 females, aged 18 to 55 years old, did not use oral corticosteroids within 6 months. During ICS treatment, patients were challenged with either FP375μg or BDP 750μg twice a day for 6 weeks with alternating intervals of 3 weeks. The baseline pulmonary function, FEV_1 and PEFR were measured before and after ICS treatment. The levels of plasma cortisol, calcium, phosphorus (P) and parathyroid hormone (PTH) and 1.25 (OH) phosphorus