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目的 观察中重度持续性哮喘儿童吸入糖皮质激素(ICS)的疗程,哮喘达到良好控制后ICS成功减停的可行性.方法 将76例年龄(8.8±2.6)岁的中重度哮喘患儿,依年龄吸入布地奈德干粉刺起始剂量为400μg/d或600μg/d,达到哮喘控制3个月以上,ICS减少50%剂量维持治疗后,每3个月减少50～100μg,停药后进行24个月的随访.结果 初始高剂量时间平均为5.7月(4～10月),总的疗程平均为26.4月(20～39月).成功减停激素的患儿有62例(90%),其中51例(82.3%)控制良好,9例(14.5%)有轻度喘息发作用,2例(3.2%)病人反复发作.治疗后发生哮喘恶化事件及相关的急诊就医、缺课、住院的患儿比率均低于治疗前(x2=58.899,73.255,94.891,4.279;P<0.001或P<0.05).结论 对于中高剂量ICS治疗的哮喘儿童达到控制并维持3个月以上,ICS减少50%用量,维持一定时间的治疗后大部分患儿激素均可以顺利的减停.“,”Objective To explore the course of inhaled corticosteroids (ICS) in moderate to severe childhood asthma, assess the possibility of successful withdrawal of ICS following a good control. Methods There 84 children (5～12 years old) with moderate to severe asthma were allocated to receive budesenide dry power 400μg/d or 600μg/d, depending on the age,once achieved asthma control for a period,ICS reduced 50% to a maintenance level,later the dosage was reduced by 50～100μg at intervals of 3 months,then followed by 24 months. Results The initial period on a high dose was 5.7 months (4～10 months) ,the mean total duration of treatment was 26.4 months (20～39 months). of the 62 children who successfully withdrawaled, 51 (82.3%) remained well, 9(14.5%) had mild episodes of wheezing, 2 (3.2%) had troublesome recurrences. Numbers (%) of patients with asthma exacerations and related events as visit to emergency department ,absece from school, admission to hospital are all lower than pretherapy (x2=58.899,73.255,94.891,4.2799; P<0.001 or P<0.05). Conclusion Children with asthma who require moderate to high dosage ICS once achieving good control for more than 3 months,ICS can be reduced by 50%. It is possible to withdraw ICS in a significant proportion asthmatic children who has been on a maintence dose for a considerable period.