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OBJECTIVE To explore the effects of ADRB2 gene regulatory region polymorphism on the efficacy of short-acting beta 2 receptor agonists （SABA） in the treatment of acute asthma attack in children. METHODS A total of 127 children with acute mild to moderate bronchial asthma who received SABA treatment for 7 days in the General Hospital of Northern Theater Command from October 2016 to October 2020 were selected to detect their genotype distribution and compare the improvement of pulmonary functional indicators and curative effect among different genotypes. The effect of the high-order interaction of gene polymorphism on therapeutic effect was investigated. RESULTS Among 127 children， there were 80， 44 and 3 cases of TT， TA and AA types at locus rs2895795， 93， 32 and 2 cases of CC， CG and GG types at locus rs11168070， and 41， 64 and 22 cases of GG， GA and AA types at locus rs12654778， respectively， in accordance with Hardy-Weinberg equilibrium （P＞0.05）. After treatment， the improvement rate of the peak expiratory flow in percent predicted value （PEF%pred） and the improvement rate of the forced expiratory flow at 75% vital capacity in percent predicted value （FEF75%pred） in children with TA type were significantly lower than that of TT type at locus rs2895795 （P＜0.05）； the improvement rates of PEF%pred and FEF75%pred in children with CG type were significantly lower than that of CC type at locus rs11168070 （P＜0.05）； the improvement rates of PEF%pred in children with GA and AA type were significantly lower than that of GG type at locus rs12654778 （P＜0.05）. The differences in fractional exhaled nitric oxide before and after treatment were not statistically significant among different genotypes at each locus （P＞0.05）. The proportion of remarkable improvement of children with TT type at locus rs2895795 was 2.358 times that of children with TA+ AA type （P＜0.05）， and there was no significant effect of higher-order interaction of ADRB2 polymorphism on the efficacy in children with asthma （P＞0.05）. CONCLUSIONS Polymorphisms in the regulatory region of the ADRB2 gene in children with bronchial asthma are associated with the efficacy of SABA in the treatment of acute asthma attack in children. At locus rs2895795， rs11168070 and rs12654778， the improvement of lung function of children with wild-type is more obvious， and the efficacy of SABA treatment on children with TT type is better at locus rs2895795.
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Objective:To translate the Pediatric Respiratory Assessment Measure into Chinese, and to test its reliability and validity.Methods:According to the Brislin translation model, the English version of Pediatric Respiratory Assessment Measure was translated into Chinese, and then was back-translated and modified for cultural adaptation. From June 2019 to December 2020, convenience sampling method was used to evaluate the severity of 50 children with acute attack of bronchial asthma aged 2-14 years in the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University, in order to evaluate its reliability and validity.Results:The Cronbach α of the Chinese version of Pediatric Respiratory Assessment Measure was 0.838, the inter-rater reliability was 0.984; the average scale-content validity index was 0.97. One common factor was extracted, the cumulative variance contribution rate of superior sternal fossa depression was 61.83%. The criterion related validity between the evaluation results of doctors, nurses, respiratory therapists and the grading standard of bronchial asthma severity in the " Guidelines for the diagnosis, prevention and treatment of bronchial asthma in children ( 2016 edition)" were 0.903, 0.884 and 0.889, the ROC curve of the scale was 0.867 (95% CI 0.754-0.980). Conclusions:The Chinese version of Pediatric Respiratory Assessment Measure has good reliability and validity, which can be used to evaluate the severity of acute attack of bronchial asthma in children aged 2-14 in China, and provide a basis for further diagnosis and treatment.
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Objective To explore the effect of budesonide suspension for inhalation in the treatment of childhood asthma and its influence on growth and development in 1-2 years. Methods The 68 children with asthma admitted to our hospital from October 2016 to January 2017 were selected. Every patient had acute attacks and received continued medication. 34 patients treated with salbutamol sulfate inhaled aerosol were used as the control group. 34 patients treated with budesonide suspension combined with salbutamol sulfate aerosol were classified as the observation group. The interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), high-sensitivity-C-reactive protein (hs-CRP), maximum respiratory flow, IS maximum expiratory volume, regulatory B cell ratio, wheezing disappearance time, shortness of breath relief time, wet rales disappearing time, cough disappearing time, and the two year follow-up indicators of growth and development were compared. Results After medication, IL-6, TNF-α, hs-CRP, regulatory B cell ratio, wheezing disappearance time, shortness of breath relief time, moist rales disappearance time, and cough disappearance time were lower in the observation group(P<0.05). The maximum respiratory flow and IS maximum expiratory volume in the observation group were higher than those in the control group (P<0.05). The GH level, height, and weight obtained from two year follow up in the observation group were lower than those in the control group (P<0.05). Conclusion Budesonide suspension combined with salbutamol sulfate aerosol inhalation therapy can alleviate the inflammatory reaction, improve the lung function and immune function of children, and accelerate the disappearance of clinical symptoms, but it will affect the growth and development of children to a certain extent.
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BACKGROUND AND OBJECTIVE: There has been little clinical data on the treatment outcome of patients with acute asthma attack in Korea. We designed a management protocol of acute asthma, and analyzed clinical p arameters obtained from this protocol. METHOD: A total of 32 cases with acute asthma were treated with oxygen, beta2 agonist, and methylprednisolone. Ipratropium was added in cases of severe attack. After 90 minutes, intravenous aminophylline was given to the patients with poor response. RESULT: Beta2 agonist and methylprednisolone were sufficient for symptom control in 17 cases. Ipratropium and aminophylline were added in 6 and 9 cases, respectively. There was no difference in improvement of PEF, heart rate, respiratory rate, PaO2, PaCO2, and SaO2 at 90 minutes and 8 hours between beta2 agonist inhalation and subcutaneous group. Serum potassium concentration levels significantly decreased in patients treated with ipratropium of aminophylline(n=15, 4.17+/-0.45 vs. 3.99+/-0.35mM/L, p0.05). CONCLUSION: Subcutaneous beta2 agonist may be an alternative to inhalant beta2 agonist for the emergency treatment of acute asthma, and we think a consensus regarding use of aminophylline in the emergency room should be made.