布地奈德在慢性阻塞性肺疾病急性加重期的临床疗效观察

目的评价局部吸入布地奈德治疗慢性阻塞性肺疾病急性加重期的疗效及安全性。方法选择60例COPD急性加重期住院患者随机均分为3组：①布地奈德组给予布地奈德雾化液雾化吸入2 mg/次,每8小时1次;②泼尼松组给予口服泼尼松片30 mg/次,每日1次;③空白对照组不使用任何糖皮质激素。观察3组患者治疗后呼吸困难评分、肺功能和动脉血气变化。结果与空白对照组比较,布地奈德组、泼尼松组在治疗后呼吸困难评分、动脉血气及肺功能的改善有显著性差异（P〈0.05）。布地奈德组与泼尼松组在提高FEV1、PaO2,改善呼吸困难评分方面无显著性差异（P〉0.05）。但在PaCO2值下降方面,在治疗7 d后布地奈德组下降（4.4±1.5）mmHg,泼尼松组下降（5.3±2.2）mmHg,两组比较有显著性差异（P〈0.05）。布地奈德组的不良反应少于泼尼松组。结论布地奈德组的疗效明显优于空白对照组,但与泼尼松组的无显著性差异。局部吸入布地奈德溶液是COPD急性加重期有效选择。

Effect of nebulized budesonide on acute exacerbation of chronic obstructive pulmonary disease

Objective To observe the therapeutic effect and security of Nebulized Budesonide（NB） on acute exacerbation of chronic obstructive plumonary disease（COPD）.Methods Sixty patients of acute exacerbation of COPD were divided into 3 groups in random,including 2 mg NB every 8 h（n=20）,30 mg oral prednisone every day（n=20）,and the blank control group not receiving any corticosteroid（n=20） with duration of treatment of 7 days,respectively.The postbronchodilator FEV1,the dyspnea score and arterial blood gases were measured and observed at 0-hour（H0）,24-hour（D1）,72-hour（D3） and day 7（D7）.Results The NB group and the prednisone group patients′dyspnea scores,pulmonary function,and arterial blood gases were greatly improved than the blank control group.Differences in terms of the dyspnea score between the NB group and the prednisone group were not statistically significant（P0.05）.but the prednisone group showed a more substantial decrease in PaCO2 than NB group（P0.05）.The values of PaCO2 decreasing from Ho to D7 in the two groups were（5.3±2.2） mmHg vs（4.2±1.5） mmHg.NB group were less than the prednisone group in the adverse reaction of drug.Conclusion The outcome of NB group is better than that of the blank control group,but the difference between NB group and the prednisone group was not significant.NB may be an alternative in the treatment of exacerbations of COPD.