吸入大剂量糖皮质激素对AECOPD疗效的临床观察

目的比较氧驱动雾化吸入大剂量糖皮质激素与全身激素对中重度慢性阻塞性肺疾病急性加重的短期疗效,观察其安全性。方法选取中重度AECOPD患者82例,随机分为A组41例为全身糖皮质激素组,B组41例为布地奈德氧雾组,治疗时间7天,观察治疗前、治疗3天、治疗7天的FEV1%预计值、血气分析和不良反应。结果治疗3天后,与治疗前两组患者的肺功能、血气分析等指标均明显改善,A组与B组相比血气分析改善略高于B组患者,但两组间未见统计学差异,两组患者肺功能未见统计学差异,B组患者不良反应发生率少于A组患者。结论大剂量糖皮质激素氧驱动吸入治疗短期内可改善AE-COPD患者的临床症状和肺功能,可替代全身糖皮质激素。

Clinical observation of curative effect of high-dose inhaled corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease

Objective To compare the short-term curative effect of oxygen atomized inhalation of high-doses corticosteroids and systemic hormones in the treatment of patients with moderate and severe acute exacerbation of chronic obstructive pulmonary disease and to observe its safety. Methods 82 patients with severe AECOPD were randomly and evenly divided into two groups. The group A was given systemic glueocortieoid, and the group B was treated with oxygen atomized inhalation of budesonide. The period of treatment was 7 days. FEV1%, blood gas analysis, and adverse reactions were observed before and 3 days after the treatment. Results 3 days after the treat- ment, pulmonary function and blood gas analysis were obviously improved, and the improvement was slightly pronounced in the group A than in the group B without statistical significance. The incidence of adverse reactions was less in the group B than in the group A. Con- elusion High-dose glucocortieoid oxygen driven inhalation can improve pulmonary function and clinical symptoms and replace the system- ic glucocortieoids in the short-term treatment of patients with AECOPD.