Long-term Effects Of Different Inhaled Glucocorticoids On Bone Metabolism Of Children With Asthma

Objective: To study the long-term effects of different inhaled glucocorticoids on bone metabolism of children with asthma,we chose two different inhaled glucocorticoids including flixotide and budesonide aerosol to give children with asthma for six month inhalation treatment.We observed the difference in the development of children after treatment with different inhaled glucocorticoids.The effects of using different inhaled glucocorticoids in long-term on bone metabolism were investigated and the calaium,phosphorus,BGP and ALP.Method: The design was a randomized,paralledled group study in 60 children from author's hospital with asthma aged 4.0-9.6 years,including 33 boys and 27 girls.The children were divided into two groups at random as group A and group B.Group A were given flixotide treatment and Group B were given budesonide aerosol treatment.According to the scheme of the global initial for asthma(GINA): infants at acute stage 200 micrograms/d,q8h;young children 400 micrograms/d,q8 h.After the asthma was under control,we used the step analgesic ladder for children according to GINA: infants in mild chronic remission 100 micrograms/d,q12d;young children in mild chronic remission 200 micrograms/d,q12d;infants in severe chronic remission 200 micrograms/d,q12d;young children in severe chronic remission 400 micrograms/d,q12 d.The treatment of the treatment group can be stepped down or stepped up according to GINA scheme.If the symptoms has released and maintained at least for 3 months,the dose can be decreased.The treatment period lasts for 6 months.The growth velocities in stature and bone metabolism markers were measured.At the same time,30 normal children were included in control group.Statistical method: inter group analysis of serum indications among group A,group B and control group use the method of analysis of variance.The growth velocities in stature among group A,group B and control group use student's t test.Results:1 There was no statistical sense in gender composition and average age among group A,group B and control group.And there was no statistical sense in child's height.After the long-term treatment,the growth velocity of group A averaged 2.94±0.42 cm/6 months,the value for group B averaged 3.09±0.37 cm/6 months,and 2.99±0.45 cm/6 months for control group.According to the results shown above,there is no statistical sense in the growth velocity in stature(P>0.05).2 Before the treatment,the calaium level of group A averaged 2.26±0.22 mmol/L,the phosphorus level averaged 0.94±0.09 mmol/L,the BGP level averaged 17.52±4.97 ng/mL and the ALP level average 67.07±8.08 U/L;the calaium level of group B averaged 2.21±0.16 mmol/L,the phosphorus level averaged 0.98±0.09 mmol/L,the BGP level averaged 16.97±3.76 ng/mL and the ALP level average 67.14±7.18 U/L;the calaium level of control group averaged 2.24 ± 0.18 mmol/L,the phosphorus level averaged 0.97±0.10 mmol/L,the BGP level averaged 17.85±4.46 ng/mL and the ALP level average 68.99±7.92 U/L.The means had no statistical sense after compared with control group.After the six months treatment,the calaium level of group A averaged 2.20±0.16 mmol/L,the phosphorus level averaged 0.97±0.11 mmol/L,the BGP level averaged 17.59±4.71 ng/mL and the ALP level average 68.00±7.62 U/L;the calaium level of group B averaged 2.23±0.18 mmol/L,the phosphorus level averaged 0.97±0.09 mmol/L,the BGP level averaged 17.26±3.70 ng/mL and the ALP level average 66.41±7.13 U/L;the calaium level of control group averaged 2.21±0.14 mmol/L,the phosphorus level averaged 0.98±0.11 mmol/L,the BGP level averaged 17.52±5.05 ng/m L and the ALP level average 69.65±7.28 U/L.There is also no statistical sense(P>0.05).1 We gave the recommended dose according to GINA scheme,and there is no significant effects on growth of children with six months long-term inhaled glucocorticoids treatment.2 With long-term recommended dose inhaled glucocorticoids treatment,there is no statistical sense in serum calcium and phosphorus(P>0.05).3 With long-term recommended dose inhaled glucocorticoids treatment,there is no statistical sense in BGP(P>0.05).4 With long-term recommended dose inhaled glucocorticoids treatment,there is no statistical sense in ALP(P>0.05).Conclusion:There are no significant effects on growth of children and bone metabolism with recommended dose of inhaled glucocorticoids.