沙丁胺醇联合异丙托溴铵吸入治疗慢性阻塞性肺疾病急性加重期疗效观察

目的比较沙丁胺醇联合异丙托溴铵与单用沙丁胺醇治疗慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）的疗效与安全性。方法AECOPD患者46例随机分为观察组和对照组各23例，对照组给予沙丁胺醇气雾剂1-2喷／次，4次／d，吸入；观察组沙丁胺醇气雾剂用法、用量同对照组，并给予异丙托溴铵气雾剂1～2喷／次，4次／d，吸入；2组疗程均为14d。比较2组疗效及不良反应发生情况，观察2组治疗前、后第1秒用力呼气容积（forced expiratory volume in one second，FEV1）占预计值百分比（FEVl％）、FEV1／用力肺活量（forced vital capacity，FVC）变化。结果观察组总有效率（91．3％）高于对照组（73．9％）（P〈0．05），不良反应发生率（4．3％）低于对照组（13．0％）（P〈0．05）；对照组治疗前、后FEV1％、FEV1／FVC比较差异无统计学意义（P〉0．05），观察组治疗后FEV1％、FEV1／FVC与治疗前及对照组比较差异有统计学意义（P〈0．05）。结论沙丁胺醇联合异丙托溴铵吸入治疗AECOPD疗效优于单用沙丁胺醇，且不良反应轻。

Clinical effect of inhaled salbutamol plus ipratropium bromide on acute exacerbation of chronic obstructive pulmonary disease

Objective To compare the clinical effect and safety of inhaled salbutamol plus ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Forty-six patients with AECOPD were randomly divided into observation group and control group, with 23 patients in each group. Control group received inhalation of salbutamol aerosol, 1 to 2 sprays per time, 4 times per day. Observation group received inhalation of salbutamol aerosol, 1 to 2 sprays per time, 4 times per day, besides the treatment in control group. Both groups were treated for 14 days as one course. The therapeutic effect and adverse reaction were compared between two groups. The forced expiratory volume in one second （FEV1）, FEV1 % and FEV1/forced vital capacity （FVC） were observed before and after treatment in two groups. Results The total effective rate was 91.3% in observation group, higher than that in control group （73.9%） （P〈0.05）, and the incidence of adverse reaction was 4. 3% in observation group, lower than that in control group （13.0%） （P〈0.05）. FEV1 % and FEV1/FVC showed a significant difference in observation group （P〈0.05）, and did not show any significant difference in control group before and after treatment （P〉0.05）. FEV1 and FEV1/FVC were significantly different between two groups （P〈0. 05）. Couelusions Inhalation of salbutamol plus ipratropium bromide is superior to salbutamol for AECOPD, and the adverse reaction is mild.