International guidelines advocate the early introduction of inhaled corticosteroids (ICS) in all types of persistent asthma. Our study was undertaken to assess the effects of ICS on bronchial hyperresponsiveness (BHR) as a hallmark of inflammation, and to assess the symptoms, the use of rescue medications, and the parameters of lung function in patients with mild intermittent asthma. The patients with intermittent asthma (n = 85) were randomly allocated to a treatment with ICS, beclomethasone dipropionate 250 microg/day and short-acting beta2 agonists salbutamol as needed (Group A, n = 45) or to a treatment with only short-acting beta2 agonists as needed (Group B, n = 40) during the 6-month treatment period. At the end of the study, in Group A, we found a statistically significant decrease of BHR (PD20 0.98 vs. 2.07) (p < 0.001), diurnal peak expiratory flow (PEF) variability (17.9 vs. 13.8) (p < 0.001), symptom scores (0.63 vs. 0.30) (p < 0.001), and used rescue medication (p < 0.001), while the parameters of lung function remained unchanged except for forced expiratory volume in 1 sec (FEV1), which had a statistically significant increase (3.58 vs. 3.66) (p < 0.001). In Group B, there was a statistically significant decrease of lung function parameters FEV1 (3.80 vs. 3.71) (p < 0.001), forced vital capacity (FVC) (4.43 vs. 4.37) (p < 0.001), FEV1/FVC (88.2 vs. 85.3) (p < 0.05), PEF (8.05 vs. 7.51) (p < 0.01), PEF variability (17.85 vs. 18.33) (p < 0.001), increased BHR (PD20 1.04 vs. 0.62) (p < 0.05), and symptom scores (0.46 vs. 0.62) (p < 0.01), as well as the use of rescue medication during the day (p < 0.001). Early introduction of low doses of ICS may be more beneficial than beta2 agonists alone in patients with intermittent asthma.

译文

:国际指南主张在所有类型的持续性哮喘中尽早引入吸入性糖皮质激素(ICS)。我们的研究旨在评估ICS对支气管高反应性(BHR)的影响,作为炎症的标志,并评估轻度间歇性哮喘患者的症状,急救药物的使用以及肺功能参数。间歇性哮喘患者(n = 85)被随机分配至接受ICS治疗,双丙酸倍氯米松250μg/天和视需要使用短效β2激动剂沙丁胺醇(A组,n = 45)或仅接受短期治疗。在6个月的治疗期内根据需要使用B2激动剂(B组,n = 40)。在研究结束时,在A组中,我们发现BHR的统计学显着降低(PD20 0.98 vs. 2.07)(p <0.001),昼间最大呼气流量(PEF)变异性(17.9 vs. 13.8)(p <0.001) ),症状评分(0.63 vs.0.30)(p <0.001)和使用的急救药物(p <0.001),而肺功能参数保持不变,除了1秒内的强制呼气量(FEV1),具有统计学意义显着增加(3.58对3.66)(p <0.001)。在B组中,肺功能参数FEV1(3.80 vs. 3.71)(p <0.001),强迫肺活量(FVC)(4.43 vs.4.37)(p <0.001),FEV1 / FVC(88.2)统计学上显着降低vs. 85.3)(p <0.05),PEF(8.05 vs.7.51)(p <0.01),PEF变异性(17.85 vs.18.33)(p <0.001),BHR升高(PD20 1.04 vs.0.62)(p <0.05 ),症状评分(0.46比0.62)(p <0.01),以及白天使用急救药物(p <0.001)。对于间歇性哮喘患者,尽早引入低剂量ICS可能比单独使用beta2激动剂更为有益。

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