目的　观察大剂量甲基强的松龙 (MPSS)治疗儿童重度支气管哮喘的临床效果。方法　对符合重度支气管哮喘诊断标准的 42例患儿随机分为MPSS普通剂量组 (A组 ) 2 0例 ,MPSS大剂量组 (B组 ) 2 2例。A组予MPSS 4mg/ (kg·d) ,B组予MPSS 2 0mg/ (kg·d) ,观察用药后临床治疗效果、动脉血气及肺功能变化。 结果　A组哮喘缓解时间为 (34 5± 6 2 )h、B组为 (2 3 6± 5 7)h ,t =5 92 ,P <0 0 1;A组哮鸣音消失时间为 (7 9± 1 5 )d、B组为 (6 2± 1 3)d ,t =3 95 ,P <0 0 1;治疗后B组动脉血气及PEFR较治疗前改善明显 (P <0 0 1) ,而A组除PaO2 外 ,其余指标改善不明显 (P >0 0 5 )。结论　大剂量MPSS冲击疗法是儿童重度支气管哮喘可选择的治疗方法。 Objective To observe the clinical effect of high dose methylprednisolone (MPSS) on children with severe bronchial asthma. Methods Forty-two children who met the diagnostic criteria of severe bronchial asthma were randomly divided into MPSS normal group (A group) 20 cases and MPSS high-dose group (B group) 22 cases. Group A received MPSS 4mg / (kg · d), Group B received MPSS 20mg / (kg · d), and observed the clinical effect of treatment, arterial blood gas and lung function changes. Results The relief time of asthma in group A was (34 ± 6 2) h, that in group B was (23 6 ± 5 7) h, t = 5 92, P <0 01; 9 ± 1 5) d in group B and (6 2 ± 1 3) d in group B, t = 3 95, P 0 01. After treatment, the arterial blood gases and PEFR in group B improved significantly compared with those before treatment (P 0 01) , While group A except PaO2 did not improve significantly (P> 0.05). Conclusion High-dose MPSS shock therapy is an effective treatment for children with severe bronchial asthma.