布地奈德联合沙丁胺醇雾化吸入对慢性阻塞性肺疾病急性发作的治疗作用

目的探讨布地奈德联合沙丁胺醇雾化吸入对老年慢性阻塞性肺疾病（COPD）急性发作期肺功能、血气分析及嗜酸性粒细胞变化的临床反应性。方法选取58例明确诊断为老年COPDⅢ级的患者，随机分成两组：对照组28例给予常规治疗，治疗组30例在常规治疗基础上给予布地奈德联合沙丁胺醇雾化吸入治疗。观察用药前后两组患者肺功能指标（第1秒用力呼气容积占用力肺活量百分比（FEV1／FVC％），第1秒用力呼气容积占预计值百分比（FEV1％预计值），呼气峰值流速（PEF））、血气分析（动脉血氧分压（PaO2），二氧化碳分压（PaCO2），血氧饱和度（SaO2）变化。结果①治疗后治疗组与对照组肺功能各指标较治疗前均有明显改善，但治疗组改善更明显（P〈0．05）；②治疗后2h血气分析指标治疗组和对照组较治疗前比较均有明显改善，但治疗组优于对照组（P〈0．05）。结论布地奈德联合沙丁胺醇雾化吸入治疗老年慢性阻塞性肺疾病急性发作期能取得满意的临床疗效，与常规治疗相比能更迅速缓解和控制COPD急性发作，可作为AECOPD首选治疗。

Therapeutical Effect of the Nebulization Inhalation Combiningg Budesonide wiht Salbutamol Treating AECOPD

Objective To evaluate the clinical effects of the nebulization inhalation combining budesonide and salbutamol on the lung function, blood gas analysis and eosinophil change of the old patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Method 58 old patients definitely diagnosed as COPD stage 111 were randomly divided into two groupsat random. The treatment group was （n=30） and the control group （O=28）. The control group took the routine treatment （inhaling oxygen, antibiotics, doxofylline, etc） ; the treatment group took nebulization inhalation combining budesonide and salbutamol based on the ordinary therapy. The level of the hmg function （FEV1/FVC%, FEV1% predicted, PEF）,blood gas analysis （PaO2 and PaCO2） were measured before and after the treatment of 2 groups. Results （1） （Compared to before treatment, the level of lung function （FEV1/FVC%, FEV1% predicted,PEF）increased obviously in both the treatment and control groups, the treatment group has a significant difference in statistics （P〈0.05）. The level in the treatment group was obviously higher than that in the control group （P〈0.05）. （2）The level of blood gas analysis （PaO2 and PaCO2 before and 2 hours after the treatment） was improved remarkably, the level before and after treatment in the both groups has significantly statistic difference P〈0. 05）. The level in the treatment group was improved more than that in the control group （P〈0.05）. Conclusion The study suggested that nebulization inhalation of combination of budesonide with salbutamol on old patients with AECOPD can achieve an effective therapy,and relieve and control acute exacerbations more quickly, which is a first choice for treatment of combination of AECOPD.