摘要

The possibility of irreversible obstruction and therefore the need for early intervention is being much debated. Some investigators suggested that delay in starting inhaled corticosteroids will result in irreversible obstruction. Our own long-term study, specifically designed to detect irreversible obstruction showed that a step-wise approach (starting with cromolyn sodium and switching to inhaled corticosteroids if clinical control and pulmonary function tests are not satisfactorily controlled) resulted in an increase in pulmonary function and not a deterioration. There was no evidence that a delay in starting inhaled corticosteroids will result in irreversible obstruction or clinical worsening. However, delay in starting cromolyn sodium in patients treated with bronchodilators alone did result in worsening pulmonary function tests and worse clinical outcomes. One study from Finland and another study from Australia came to the same conclusion. Even though some studies with cromolyn sodium did not show benefit in the first year of life, other studies did show a good response. The choice between nonsteroidal drugs, such as cromolyn sodium and inhaled corticosteroids as first-line drugs, has to be made on the risk/benefit ratio of these drugs. Although in severe asthma inhaled corticosteroids have greater efficacy, in mild-to-moderate asthma there is comparable efficacy, and the nonsteroidal drugs have better safety. A step-wise approach is still a logical approach

译文

不可逆转的阻碍的可能性以及因此早期干预的必要性正在进行大量辩论。一些研究者认为延迟开始吸入皮质类固醇会导致不可逆的阻塞。我们自己的长期研究, 专为检测不可逆阻塞而设计的方法表明,循序渐进的方法 (如果临床控制和肺功能测试没有得到令人满意的控制,从 cromolyn 钠开始,转向吸入皮质类固醇) 导致肺功能的增加而不是恶化。没有证据表明延迟开始吸入皮质类固醇会导致不可逆的阻塞或临床恶化。然而,仅使用支气管扩张剂治疗的患者延迟开始使用克罗莫林钠确实会导致肺功能测试恶化和临床结果恶化。芬兰的一项研究和澳大利亚的另一项研究得出了同样的结论。尽管一些服用克罗莫林钠的研究在生命的第一年没有显示出益处,但其他研究确实显示出良好的反应。非甾体类药物之间的选择,如 cromolyn 钠和吸入皮质类固醇作为一线药物,必须根据这些药物的风险/效益比进行。虽然在重度哮喘中吸入糖皮质激素具有更大的疗效,但在轻中度哮喘中具有相当的疗效,并且非甾体类药物具有更好的安全性。循序渐进的方法仍然是合乎逻辑的方法

cromolyn sodium

呼吸 非激素类吸入抗炎药物 药物
概述  :  

在支气管哮喘的现代治疗学中,色甘酸钠吸入剂扮演了十分重要的角色。因为它具有抗气道变应性炎症和几乎无不良反应的特点。色甘酸钠是非激素类吸入抗炎药物,其药理机制是稳定肥大细胞膜、抑制肥大细胞IgE介质的释放,降低呼吸道末梢感受器的兴奋性。由于此类药物使用安全,现已成为治疗哮喘的首选药物。 作用机制 色甘酸钠的肥大细胞膜稳定作用是其治疗哮喘的最早机制,与阻断钙离子内流、阻断肥大细胞内的酶活性、抑制磷酸二酯酶活性、稳定细胞内颗粒等有关

Cromolyn   /k'rɒməʊlɪn/

释    义   色甘酸

例    句   Importantly, treatment with the mast cell stabilizer cromolyn does prevent all the adverse phenomena elicited by mast cell activation. 更重要的是,肥大细胞稳定剂色苷酸的处理能够阻止上述由于肥大细胞活化所引起的所有不良现象。

 

Sodium   英 /ˈsəʊdiəm/   美 /ˈsoʊdiəm/

释    义   n. [化学] 钠

例    句   But as man evolved in the hot climate of Africa, perspiration robbed the body of sodium.不过由于人类在非洲这种炎热的气候中进化,汗水带走了身体中的钠。

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