雾化吸入布地奈德混悬液对慢性阻塞性肺疾病急性加重期患者的治疗作用及安全性评估

目的　探讨短期雾化吸入布地奈德混悬液对慢性阻塞性肺疾病急性加重期（AECOPD）患者的治疗效果及安全性评估。方法　87例AECOPD患者被随机分为吸入激素组（31例）、全身激素组（27例）和对照组（29例）。三组均给予吸氧、抗感染、氨茶碱及止咳化痰等常规治疗。吸入激素组加用布地奈德混悬液氧气雾化吸入。全身激素组在常规治疗的基础上加用泼尼松龙40mg，静脉给药。三组均于治疗前及治疗7d后测定肺功能、动脉血气及空腹血糖、电解质。结果　治疗前，三组间各指标比较无明显差异。治疗后，三组肺功能及动脉血气较治疗前均有明显改善（P〈0．01或P〈0．05）；吸入激素组与全身激素组比较，除血糖外（P=0．044），各指标差异无显著性（P均〉0．05）；吸入激素组与对照组比较，除pH值外，肺功能、血气指标差异均显著，血糖、电解质比较差异无显著性（P均〉0．05）。结论布地奈德混悬液雾化吸入治疗AECOPD安全有效。

Efficacy and safety of inhating budesonide suspension in treatment of acute exacerbations of chronic obstructive pulmonary disease

Objective To evaluate the efficacy and safety of inhaling budesonide suspension with oxygen in acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods Eighty-seven patients with AECOPD were randomly divided into three groups (inhalation group 31 cases,IV injection group 27 cases and control group 29 cases).The patients in control group were treated with standard therapy only,the patients in inhalation group attached to inhaling budesonide suspension with oxygen,and those in IV injection group were treated with both standard therapy and IV injection prednisolone.All the patients underwent pulmonary function test,arterial blood gas analysis,and blood glucose,sodium,potassium,and chloride respectively at entry and seven days after therapy.Results There were significant improvement of all pulmonary function and arterial blood gas relevant parameters among three groups after therapy (P<0.01 or P<0.05).After therapy,all relevant parameters of inhalation group showed no significant difference (all P>0.05) than those of IV injection group except blood glucose(P=0.044).FEV1,FEV1/FVC,percent predicted FEV1,PaO2 and PaCO2 were much higher in inhalation group than in control group after therapy (P =0.000,0.000,0.015,0.000 and 0.020,respectively),but pH and blood glucose,sodium,potassium,and chloride showed no significant difference(all P>0.05).Conclusions Budesonide inhalation suspension,2.0 mg twice daily,with oxygen is an effective and safe treatment for AECOPD patients.