糖皮质激素对慢性阻塞性肺疾病急性期的疗效观察

目的观察在综合治疗基础上，使用糖皮质激素对慢性阻塞性肺疾病（COPD）急性加重期的临床疗效。方法慢性阻塞性肺疾病急性加重期患者随机分为地塞米松组、甲强龙组和普米克令舒组。综合治疗给予氧疗、抗感染、止咳、祛痰、纠正酸碱平衡等；在上述治疗基础上加用静脉滴注地塞米松（5mg Qd，共3天）、甲基强的松龙（80mg Qd，共3天），雾化吸入普米克令舒（2mg Q8 h，共3天）治疗。3组患者治疗后进行临床症状评分、检测肺功能和动脉血气变化等参数，并进行对比分析。结果各治疗组生活质量明显改善，治疗后肺功能检查FEVl和FEVl／FVC明显高于治疗前，地塞米松组与甲强龙组、普米克令舒组比较差异有非常显著性（P〈0．01），甲强龙组与普米克令舒组比较无统计学差异（P〉0．05）。普米克令舒组的不良反应少于地塞米松组和甲强龙组。结论糖皮质激素对COPD急性加重期有较好的近期疗效，普米克令舒疗效明显优于地塞米松，但与甲强龙疗效的差异无显著性。普米克令舒雾化治疗是COPD急性加重期糖皮质激素治疗的有效选择。

Clinical Study of Glucocorticostteroid on Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To observe the clinical effect of glucocorticostteroid on acute exacerbation of chronic obstructive pulmonary disease based on comprehensive treatment.Methods Acute exacerbation of chronic obstructive pulmonary disease(COPD) were randomly divided into three treatment groups: dexamethasone group,solu-medrol group and pulmicort respules group.These groups were given antibiotics,oxygen and treatment for expectoration,relieved cough and retrieved acid-base equilibrium.Each group was given the therapie...