糖皮质激素类联合肾上腺素能β激动剂对慢性阻塞性肺疾病急性加重期患者的疗效分析

目的 探讨糖皮质激素类联合肾上腺素能β激动剂对慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效.方法 选取AECOPD患者100例,依据随机数字表法分为联合用药组和对照组,每组50例.对照组给予常规对症和布地奈德雾化吸入治疗,联合用药组在此基础上加用沙丁胺醇雾化吸入治疗.调查所有患者治疗前后肺功能、血清肿瘤坏死因子-α、白细胞介素-8、C-反应蛋白、不良反应、病情严重程度和生活质量情况.结果 联合用药组治疗后1秒用力呼气量、肺总量、1秒用力呼气量用力肺活量百分比显著高于对照组(P<0.05);联合用药组治疗后血清肿瘤坏死因子-α、白细胞介素-8、C-反应蛋白水平低于对照组(P<0.05),治疗后1个月、3个月慢性阻塞性肺疾病评估测试评分和St George呼吸疾病问卷得分低于对照组,差异有统计学意义(P<0.05);两组治疗期间不良反应发生率、治疗后6个月慢性阻塞性肺疾病评估测试评分和St George呼吸疾病问卷得分差异无统计学意义(P>0.05).结论 糖皮质激素类联合肾上腺素能β激动剂治疗可有改善AECOPD患者的肺功能、炎症状态、病情、生活质量和提高疗效,且具有良好的安全性.

Effect of glucocorticoid hormones combined adrenergic beta agonist in patients with acute exacerbation chronic obstructive pulmonary disease

Objective To discuss the effect of glucocorticoid hormones combined adrenergic beta agonist in patients with acute exacer-bation chronic obstructive pulmonary disease ( AECOPD ) . Methods One hundred patients with AECOPD were assigned into two groups:combination group (n=50) and control group (n=50) according to the random number table. Patients in control group were given budesonidewhilepatients in combination group were given salbutamol and budesonide. The pulmonary function,tumor necrosis fac-tor-alpha,interleukin-8,C-reactive protein,adverse reactions,severity of the disease and quality of life were studied before and after treatment. Results 1-second forced expiratory volume,total lung volume and the percentage of 1-second forced expiratory volume-to-to-tal lung volume in combination group were significantly higher than those incontrol group (P<0. 05). The level of tumor necrosis fac-tor-alpha,interleukin-8 and C-reactive protein in combination group were lower than those in control group after treatment (P<0. 05);the score of COPD assessment test and St George′s respiratoryquestionnaire in combination group were significantly lower than those in control group1 month and 3 months after treatment (P<0. 05). The scores of COPD assessment test,St George's respiratoryquestion-naire 6 months after treatment and the adverse reaction rate during treatment in two groups were notsignificantly different(P>0. 05). Conclusions Glucocorticoid hormones combined adrenergic beta agonist treatment can improve lung function, inflammation, state of illnessand thequality of lifein patients with AECOPD,which achieves satisfactory efficacy and safety.