雾化吸入布地奈德混悬液在AECOPD的作用

目的以随机、对照试验比较雾化吸入布地奈德混悬液和口服泼尼松龙对AECOPD的作用。方法实验分3组，布地奈德组给予布地奈德雾化液4mg，雾化吸入，每12h1次；泼尼松龙组给予泼尼松龙片20mg，口服，每天2次，7d后减为10mg口服，每天2次；对照组不使用任何糖皮质激素。观察期为24、48h,7d和14d。结果布地奈德组、泼尼松龙组与对照组比较，FEV1、PaO2、PaCO2、pH改善值具有显著性差异（P〈0．05）；布地奈德组、泼尼松龙组两组各项指标改善程度相似（P〉0．05），但布地奈德组副作用明显低于泼尼松龙组（P〈0．05）。结论雾化吸入布地奈德混悬液可有效改善AECOPD的气流受限，疗效与口服泼尼松龙相似，全身副作用小，可作为皮质激素治疗的另一选择。

The effects of nebulized budesonide and oral prednisolone with placebo in the treatment of acute exacerbations of chronic obstructive pulmonary disease

Objective In this randomized, placebo-controlled trial, the effects of nebulized budesonide(BUD), oral prednisolone(PRED), and placebo(PLACEBO) was compared in 54 patients with acute exacerbations of COPD requiring hospitalization. Methods Eligible patients were randomly allocated to one of the three treatment groups, that is, BUD, PRED, or PLACEBO. The BUD group received BUD nebulized suspension. by exacerbation with 4mg every 12h. The PRED group was treated with 20 mg by mouth every 12 h and afer a week was treated with10 mg. The placebo was offered common treatment and not treated with adrenocortical hormones. All groups were observed for 24, 48 h, 7 d and 14 d. Results Both budesonide and prednisolone improved in FEV1, PaO2, PaCO2 and pH when compared with placebo(P<0.05).The difference in FEV1, PaO2, PaCO2, pH between budesonide and prednisolone was not significant (P>0.05). The occurrence of serious adverse events in the BUD group were lower than the PRED group(P<0.05).Conclusions Both budesonide and prednisolone improved obstruent airflow in COPD patients. Nebulized budesonide may be an alternative to oral prednisolone in the treatment of nonacidotic exacerbations of COPD with lower adverse events.