Research On The Effect Of Bronchial Asthma And Inhaled Corticosteroids On The Growth And Development In Children

PART1RESEARCH ON THE EFFECT OF BRONCHIALASTHMA ON THE GROWTH AND DEVELOPMENT INCHILDRENObjective:Among chronic diseases in children, bronchial asthma isconsidered a common cause of influencing children’s growth anddevelopment, The purpose of this research was to explore whetherBronchial asthma affect children’s height,weight and BMD ornot,which can provide a reference of standard treatment for children’sBronchial asthma.Methods:600children with asthma at the beginning of treatment werecollected in our respiratory department from March2010to October2011, Height、Weight and BMD were measured, compared with388healthy children in the same age in the Child health clinic of ourhospital in the same period. Results:1Compared with the control group, the percentage of height andweight in asthma group was different levels decreased, The percentageof height and weight was significantly lower in severe group than inmild-moderate group and control group (P<0.05).2The value of height and weight of asthma children had aNegative relation with the asthma frequency, Correlation coefficient is-0.261、-0.25respectively，P<0.01.395%confidence interval（95%CI）of Z-Score in asthma groupwas lower than in control group, there was significant difference(t=7.229,P=0.000). There were significant differences of the speed ofsound(SOS) in different degrees asthma group and controlgroup(（F=20.040,P=0.000）). The SOS in the moderate group and inthe severe group were significantly lower than the same age children ofthe mild group and the control group (P<0.05）,there was nostatistically significant between the mild group and the control group(P=0.410), there was also no statistically significant between themoderate group and the severe group (p=1.000).4The course of Bronchial asthma had a negative relation withBone mineral density(r=-0.442,P＜0.01).Conclusion:1Bronchial asthma has influence on children’s height、weight and PART2RESEARCH ON THE THERAPEUTIC AND EFFECTON THE GROWTH AND DEVELOPMENT IN CHILDREN OFINHALED CORTICOSTEROIDS FOR ONE YEARObjective:Inhaled corticosteroids is the first drug for long-term control inchildren with asthma, children’s parents have a deep concern about whetherBronchial asthma affect children’s growth and development or not, so thatinfluencing long-term control therapy of Inhaled corticosteroids. Thepurpose of this study was to explore whether inhaled corticosteroids for1year had a harmful effect on children’s Height、Weight and BMD, At thesame time, We observed and compared the efficacy of different drugadministration methods-standardization inhaled corticosteroids treatment Bone mineral density.2The more serious and frequent the asthmatic attacks are, themore effects they have on children’s height and weight.3The more serious and longer course of the asthmatic attacks are,the more effect they have on children’s Bone mineral density. Methods:Seventy-three children with moderate-severe asthma were divided intoexperimental group and control group on a voluntary basis, the42cases ofA group were under treatment schedule which GINA recommended,31cases of B group were received irregular treatment. The following indiceswere observed: The change of height、weight and bone mineral density,pulmonary function(FEV1%、PEF%、FEF75%、FEF50%and FEF25%),The frequency of asthmatic attack, Trips to the hospital emergency room,Times of hospitalization, Number Of Using ventolin, The total dose ofICS one year, Drug adverse reaction.Results:1The height growth rate of non-standardization using drug group wassignificantly slower than the standardization using drug group and healthychildren (P<0.05). There was significant difference of height growth ratebetween the standardization using drug group and the non-standardizationusing drug group after the ninth month.2The Weight gain rate of standardization using drug group was thefastest, the non-standardization using drug group was the slowest on theweight growth. However, there were no significant differences on Weightand Weight gain rate among the three groups.3Z-Score of Bone mineral density in the standardization using drug group and non-standardization using drug group were increased aftertreatment. Z-Score of the standardization using drug group was significantincreased after one year’s treatment, but there was no significant differencein non-standardization using drug group after one year’s treatment.4There was significantly increased after treatment on each item ofpulmonary function in the standardization using drug group (P<0.05). Thepercentage of FEV1and PEF were significantly increased after treatment inthe non-standardization using drug group, but the percentage of FEF75,FEF50and FEF25had no obvious rise even fell in the non-standardizationusing drug group.5Through the clinical follow-up, we can find that each item ofpulmonary function was significantly increased in the standardization usingdrug group compared to the non-standardization using drug group(P<0.01).6The attack frequency, Trips to the hospital emergency room andhospitalization of the standardization using drug group andnon-standardization using drug group were significantly decrease after oneyear’s treatment, which was more obviously in the standardization usingdrug group.7Compared to non-standardization using drug group, The number ofone year’s intake of ventolin was significantly decrease in thestandardization using drug group (P<0.05). 8The dose of fluticasone propionate was significantly higher in thestandardization using drug group than in the non-standardization using druggroup (P<0.05).Conclusion:1After one year standardized treatment, They had no harmful effect onchildren’s Height, Weight and BMD in the experimental group.2Because of non-standardized asthma treatment in the B group,asthmatic children’s symptoms didn’t reach good control, whichinfluenced children’s Height, Weight and BMD.3Each item of pulmonary function was obviously improved afterstandardized treatment. small airway lung function was no obviousimprovement after non-standardized treatment.