慢性喘息症例におけるプレドニゾロン3日間投与と2週間投与との比較からみた短期経口ステロイド療法の投与期間に関する一考察  [in Japanese] A COMPARISON OF A 3DAY COURSE WITH A 2 WEEK COURSE OF ORAL PREDNISOLONE IN PATIENTS WITH CHRONIC ASTHMA  [in Japanese]

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Abstract

慢性喘息症例に対する短期経口ステロイド3日間投与(3D)と2週間投与(2W)の治療成績を比較検討した.投与前1週間, および投与後1から4週目のピークフロー値(PEF)は自己最良値の, 3Dでは63, 73, 67, 67, 65%, 2Wでは60, 76, 80, 76, 76%で, いずれも経時的にみると有意に改善していた.β_2刺激薬の吸入回数や症状点数は2Wにおいてのみ有意に改善していた.救急受診数には両群に有意差はなく, 入院した症例はなかった.3Dでは経口ステロイドの追加投与を要した症例が65%存在したが, 追加が不要であった35%の症例では, 投与3日目にPEFは自己最良値の78%に達し, 救急受診は皆無であった.これらの結果から, 3Dの効果は総合的にみて2Wに劣るものの, 35%の症例で十分な投与期間であり, 初期投与期間としては必ずしも不適当ではないと考えられた.3Dで不十分な場合には投与を延長する必要があるが, 2WでのPEFの改善が投与期間の前半で後半に比べて著明であった(改善率:34vs.6.1%, p<0.01)ことから, 2Wまでの延長は不要ではないかと思われる.

To investigate an appropriate duration of short course of a oral prednisolone (PSL), we compare the results of a 3day couse of PSL (3D) with those of a 2 week course of PSL (2W) in 20 patients with chronic asthme. All subjects had been inhaling beclomethasone dipropionate (BDP, mean daily dose : 1325μg), and had been self-monitoring their peak expiratory flow rate (PEF) for at least 6 months. Mean±SE of the best PSL-induced PEF in 2W (2W-best) was not different from that in 3D(397±29 and 356±23 L/min, respectively. p=0.26). Mean weekly morning PEF/2W-best before and 1, 2, 3 and 4 weeks after PSL was 60, 76, 80, 76 and 76% in 2W, and 63, 73, 67, 67 and 65% in 3D, respectively. Both changes over the course of time were significant. The frequency of emergency room visits and/or unscheduled hospital visits was not significantly different between 2W and 3D. However, both the frequency of use of inhaled β_2 agonists and the symptom score significantly decreased only in 2W. Seven patients (35%) did not need additional ora; PSL durng the 4-week period after initiating 3D, and among these patients, emergency room visits and/or unscheduled hospital visits were completely controlled. In conclusion, although the effect of 3D was inferior than that of 2W, it was a sufficient duration in 35% of the patients, and thus, may be appropriate as a initial duration course of rescue of oral steroids.

Journal

  • Japanese Journal of Allergology

    Japanese Journal of Allergology 47(5), 543-549, 1998

    Japanese Society of Allergology

References:  18

Cited by:  1

Codes

  • NII Article ID (NAID)
    110002404835
  • NII NACSIS-CAT ID (NCID)
    AN00012583
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0021-4884
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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