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目的探讨我国哮喘儿童吸入皮质激素的疗效及安全性。方法研究５０例间歇发作型及轻度持续发作型哮喘儿童吸入不同剂量（２００～１２００μｇ／ｄ）皮质激素（二丙酸倍氯松，ＢＤＰ）的肺功能、气道高反应性及下丘脑－垂体－肾上腺轴（ＨＰＡＡ）功能的变化。将５０例哮喘患儿随机分为５组（每组１０例），分别吸入安慰剂及ＢＤＰ２００，４００，８００，１２００μｇ／ｄ。结果经过３个月的治疗，各治疗组的第１秒用力呼气容积（ＦＥＶ１），最高呼气流速（ＰＥＦ）及ＰＤ２０－ＦＥＶ１均显著升高，而对照组则无明显变化。治疗前后各组患儿的血浆ＡＣＴＨ及血清皮质醇基础值均无明显变化，血浆皮质醇对ＡＣＴＨ刺激的反应值在对照组及ＢＤＰ２００μｇ组无明显变化，而在ＢＤＰ≥４００μｇ／ｄ时则明显下降。结论２００μｇ／ｄ的ＢＤＰ能有效地改善哮喘儿童的肺功能，降低气道高反应性，但当剂量≥４００μｇ／ｄ时，则可能引起血皮质醇对ＡＣＴＨ刺激的反应性抑制。临床上使用ＢＤＰ吸入疗法治疗间歇发作型及轻度持续发作型儿童哮喘时，尽可能将剂量控制在每日４００μｇ以下
Objective To investigate the efficacy and safety of inhaled corticosteroids in asthmatic children in our country. Methods The lung function, airway hyperresponsiveness and hypothalamic-bronchiole hyperresponsiveness in 50 intermittent and mild persistent asthmatic children with different doses (200 ~ 1200 μg / d) of corticosteroids (BDP) Pituitary - adrenal axis (HPAA) changes in function. Fifty children with asthma were randomly divided into 5 groups (10 in each group), and were given placebo and BDP200, 400, 800 and 1200μg / d respectively. Results After 3 months of treatment, FEV1, PEF and PD20-FEV1 in each treatment group were significantly increased, while those in the control group showed no significant changes. Before and after treatment, plasma ACTH and serum cortisol in each group had no significant change in the baseline values of plasma cortisol on ACTH stimulation in the control group and BDP200μg group no significant change in the BDP 400μg / d was significantly decreased . Conclusion 200μg / d BDP can effectively improve pulmonary function and reduce airway hyperresponsiveness in asthmatic children. However, when the dose of 400μg / d is higher than 400μg / d, it may cause the inhibition of ACTH stimulation by blood cortisol. Clinically using BDP inhalation therapy for intermittent and mild persistent episodes of childhood asthma, the dose as much as possible to control the daily 400μg