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糖皮质激素在支气管哮喘的长期控制性治疗和急性发作期治疗中均具有重要地位。支气管哮喘系气道慢性炎症性疾病。糖皮质激素长期使用,能有效控制慢性气道炎症所致气道高反应性,减少和减轻哮喘反复发作,更有利于达到哮喘控制。吸入糖皮质激素(ICS)直接作用于呼吸道,局部药物浓度高,抗炎作用强,全身不良反应较轻,可作为长期控制性治疗的首选药物。对于病情严重度属轻度持续,或遗忘未经规范治疗的初诊病人,可首选倍氯米松、布地奈德或氟替卡松作吸入治疗。如属中度持续或单独ICS吸入治疗症状仍有反复发作者,则建议联合使用长效肾上腺素β_2-受体激动剂(LABA)即ICS/ LABA,如氟替卡松/沙美特罗或布地奈德/福莫特罗。应定期评估病情演变和治疗效果,适时调整治疗方案。糖皮质激素静脉用药在救治重危哮喘急性发作中起重要作用,如甲泼尼龙、泼尼松或泼尼松龙,口服用药可作为序贯治疗或部分激素依赖慢性持续性哮喘的长期治疗,但不良反应多。
Glucocorticoids play an important role in the long-term controlled and acute exacerbation of bronchial asthma. Bronchial asthma is a chronic inflammatory disease of the airways. Long-term use of glucocorticoids, can effectively control airway hyperresponsiveness caused by chronic airway inflammation, reduce and reduce repeated episodes of asthma, and more conducive to asthma control. Inhaled glucocorticoid (ICS) directly on the respiratory tract, local drug concentration, anti-inflammatory effect, systemic adverse reactions, can be used as long-term controlled treatment of choice drug. For the severity of the disease is mildly persistent, or forgotten untreated newly diagnosed patients, the preferred choice of beclomethasone, budesonide or fluticasone for inhalation therapy. In the case of repeated episodes of moderate or continuous ICS inhalation therapy, it is recommended that a combination of long-acting adrenergic β 2 -receptor agonist (LABA), ICS / LABA such as fluticasone / salmeterol or budesonide / Formoterol. Should be regularly assessed the evolution and treatment of disease, timely adjustment of treatment options. Glucocorticoid intravenous drug plays an important role in the treatment of acute exacerbation of critically ill asthma, such as methylprednisolone, prednisone or prednisolone, oral administration can be used as long-term treatment of sequential or partial hormone-dependent chronic persistent asthma, However, many adverse reactions.