| PART 1 EFFICACY OF CONTINUOUS OR INTERMITTENT INHALATION OF CORTICOSTEROIDS IN TREATMENT OF PEDIATRIC ASTHMA AND ITS EFFECTS ON GROWTH AND DEVELOPMENTObjectiveTo observe the efficacy of continuous or intermittent inhalation of salmeterol/fluticasone propionate (SM/FP) in the treatment of pediatric asthma and its effects on growth and development.MethodsA total of 112 children diagnosed with bronchial asthma between September 2012 and October 2013 were assigned to standardized treatment (standard group, n=56) and non-standardized treatment (intermittent group, n=56). Comparisons of clinical symptom scores and main pulmonary function indicators between the two groups were carried out before treatment and at 6 and 12 months after treatment. The growth velocity and changes in body mass index (BMI) were observed in the two groups.ResultsAt 6 and 12 months after the treatment, the standard group had significantly reduced clinical symptom scores and significantly increased pulmonary function indicators (percentage of predicted peak expiratory flow, PEF%; percentage of forced expiratory volume in 1 second, FEV1%) (P<0.05); the intermittent group had significantly reduced clinical symptom scores and significantly increased FEV1%(P<0.05), but PEF% was significantly increased only at 6 months after treatment (P<0.05). At 12 months after treatment, the standard group had significantly lower clinical symptom scores and significantly higher PEF% and FEV1% when compared with the intermittent group (P<0.05). The growth velocity and BMI showed no significant differences between the two groups at 6 and 12 months after treatment (P>0.05).ConclusionCompared with intermittent inhalation, long-term regular inhalation of SM/FP performs better in controlling clinical symptoms and enhancing pulmonary function. Inhalation of SM/FP for one year reveals no apparent effect on the growth and development of these children.PART 2 THE INFLUENCE OF INHALED CORTICOSTEROIDSON THE GROWTH AND DEVELOPMENT IN DIFFERENT AGE STATES OF CHILDRENObjectiveTo explore the influence of inhaled corticosteroids on the growth and development in different age states of children.Methods160 children with newly diagnosed asthma were collected in respiratory department of Children’s Hospital of Chongqing Medical University from March 2013 to February 2015.Bassed on the age, they were divided into group A (infants and toddlers group,30 cases), group B (preschool children group,70 cases),group C (school age children group,41 cases), and group D (adolescents,19 cases). Height, weight were measured at the beginning and every three months interval. Growth hormone(GH), insulin like growth factor-1(IGF-1),insulin-like growth factors binding protein-3(IGFBP-3) were also measured at enrollment and at the end of one year of treatment in 15 children.ResultsDuring one year of observation, group C experienced lower height growth rate than group A and group D. Group D had faster weight growth rate than group A and group B. The body mass index (BMI) of four groups shown no obvious differences during the observation. When it comes to height growth in each time stage, only group B had the lowest height growth in 0-3 month period when compared with other periods. Weight gain in each stage during the observation period revealed no differences. All groups had the highest zero growth percentage in the 0-3 month period, especially in group B and C, and zero growth percentage in the 0-3 month period in group B shown statistical significance when compared with other periods. GH、IGF-1 and IGFBP-3 measurements in the 15 children had no statistical difference during one year of follow up.ConclusionInhaling corticosteroids in asthmatic children for one year reveals no apparent effect on the height growth rate、body weight and BMI. But height growth rate、body weight and BMI may show different degree of transient suppressive effect individually in each stage of age. GH、IGF-1、GFBP-3 levels had no obvious changes in children who inhaled corticosteroids for one year. |
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