糖皮质激素治疗AECOPD有效的预测因素

目的探讨糖皮质激素治疗AECOPD有效的预测因素。方法选取AECOPD患者189例,在常规治疗的基础上给予甲泼尼龙针,同步吸入布地奈德。观察动脉血气、肺部啰音、呼吸困难评分、血中嗜酸性粒细胞等指标。结果有效128例,治疗前肺部哮鸣音范围、体重、既往激素疗效、痰的性状及24小时痰量、血中嗜酸性粒细胞,治疗后两组呼吸困难分级评分及FEV1等指标存在显著性差异(P<0.05),有统计学意义,余指标无统计学意义。结论①既往激素疗效,②双肺哮鸣音范围及分布,③体重,④痰的性状,24小时痰量,⑤血中嗜酸性粒细胞等可作为糖皮质激素治疗AECOPD有效的预测因素。

Effective predictor factors of glucocorticoid in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To investigate the prognostic influence of glucocorticoid in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods On the basis of conventional treatment,189 AECOPD patients were given the therapy of methylprednisolone and budesonide inhalation.Their arterial blood gas analysis,pulmonary rales,dyspnea score and eosinophils in the blood were observed.Results 128 patients were effectively treated.The improvement of rales of pulmonary wheeze,body mass,prior curative effect of hormone,sputum traits,amount of 24-hour expectoration,eosinophils in blood,dyspnea score and FEV1 was more pronounced after the treatment（P0.05）.The rest indicators had no significant differences before and after the treatment.Conclusion The effective predictor factors include prior curative effect of hormone,wheeze range and distribution in double lung,body mass,sputum traits,amount of 24-hour expectoration,and eosinophils in blood in the prognosis of AECOPD patients.