The influence to airway responsiveness of asthmatic children treated with low dose azithromycin
10.3760/cma.j.issn.1673-4408.2012.03.029
- VernacularTitle:小剂量阿奇霉素对哮喘儿童气道反应性的影响
- Author:
Zheng WANG
;
Changshan LIU
;
Jing YANG
;
Xia LI
- Publication Type:Journal Article
- Keywords:
Macrolides;
Azithromycin;
Asthma;
Airway responsiveness
- From:
International Journal of Pediatrics
2012;39(3):311-315
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influence to airway responsiveness by using low dose azithromycin in asthmatic children.Methods One hundred and four children with moderate persistent or severe persistent asthma were divided into Group A (include 56 cases) and Group B (include 48 cases) randomly.All of the patients were treated with seretide (50/100 μg/dose) 2 doses/d for4 weeks.Children with severe persistent asthma were added with montelukast 5 mg/d orally,children accompanied with allergic rhinitis were added with nasonex 100 ～200 μg/d intranasal.And four weeks later,all of the patients were given a 12-week observation.Group A kept on treating with seretide (the same dose as before),and azithromycin 7.5mg/ (kg·d) (the maximal dose was 250 mg/d) orally was administered intermittently twice a week.Group B kept on treating with seretide ( the same dose as before) only.At the end of the study,we assessed the number of days with asthmatic symptoms in two groups respectively.At the beginning and the end of the study,we measured the forced expiratory volume in one second (FEV1 ％ ),peak expiratory flow (PEF％),the PD20-FEV1 by histamine challenged at the 15 th day and at the end of the study in two groups.Twenty-four hours before the study and twenty-four hours after the study,we measured the 24-hour urinary 17-OHCS and 17-KS of the patients.Two weeks after the study,we measured the serumal ALT and AST of the patients.Results ( 1 ) The number of days with asthmatic symptoms was ( 2.13 ± 1.18 ) d and ( 2.25 + 1.19 ) d respectively in Group A and B,and there was no significant difference between two groups ( t =0.54,P=0.59).(2) The PEF％ before and after the study in Group A was (49.77 ± 15.02)％ and (82.73 ±7.81 ) ％ respectively ( t =16.59,P =0.000).The PEF％ before and after the study in Group B was (52.69±13.90)％ and (81.15±7.28)％ respectively (t=12.37,P=0.000).The FEV1％ before and after the study in Group A was (50.48 ± 15.08 ) ％ and ( 83.18 ± 6.61 ) ％ respectively ( t =16.25,P =0.000).The FEV1 ％ before and after the study in Group B was ( 53.29 ± 13.89 ) ％ and ( 82.73 ± 6.10 ) ％ respectively (t=12.83,P=0.000).(3) The PD20-FEV1 at the 15 th day and at the end of the study in Group A was (65.13 ±26.08) μg and (460.79 ±221.72) μg respectively (t =13.54,P =0.000).The PD20-FEVt at the 15th day and at the end of the study in Group B was ( 65.27 ± 25.75 ) μg and (65.66 ± 25.09 ) μg respectively (t =1.45,P =0.15).Compared the PD20-FEV1 between the two groups,there was significant difference at the end of the study (t =13.29,P =0.000).(4) The 24-hour urinary 17-OHCS was (14.27 ±3.41)nmol/L and (14.43 ±3.69) nmol/L respectively of Group A and was (14.31 ±3.66)nmol/L and ( 14.56 ± 3.37 ) nmol/L respectively of Group B before and after the study,and there was no significant difference between Group A and Group B.The 24-hour urinary 17-KS was ( 22.43 ± 5.69 ) nmol/L and (22.07±5.21 ) nmol/L respectively of Group A and was (22.40±5.04) nmol/L and (22.54 ±4.74)nmol/L respectively of Group B before and after the study,and there was no significant difference between Group A and Group B.(5) The serumal ALT of Group A and B measured 2 weeks after the study was (20.39± 9.12) U/L and ( 20.83 ± 7.83 ) U/L respectively ( t =0.26,P =0.79 ).The serumal AST of Group A and Group B measured 2 weeks after the study was (20.68 ±8.67) U/L and (21.44±8.60) U/L respectively (t =0.45,P =0.66 ).Conclusion It can significantly decrease the bronchial hyperreactivity of asthmatic children treated with low dose azithromycin orally for 12 weeks and seretide inhaled,but it can not decrease the number of days with asthmatic symptoms in the patients,can not improve the FEV1 and PEF significantly.There wasn't any influence on adrenal glands.function and liver function of the patients.
