吸入与系统应用糖皮质激素治疗慢性阻塞性肺疾病急性加重的疗效对比

目的比较吸入与系统应用糖皮质激素治疗慢性阻塞性肺疾病急性加重（AECOPD）的疗效及安全性。方法选择我院符合标准的AECOPD中度和重度患者99例，随机分为治疗组48例，晨起系统应用糖皮质激素；对照组51例，雾化吸入布地奈德混悬液2mg，2次／d。观察两组患者第一秒用力肺活量（FEV1）、挠动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）及呼吸困难评分的改善情况。结果两组患者治疗前FEV1、PaO2、PaCO2和呼吸困难评分间差异均无无统计学意义（P〉0．05）。两组患者治疗后FEV1、PaO2、PaCO2和呼吸困难评分间差异均有统计学意义（P〈0．05）。结论AECOPD患者首选系统应用糖皮质激素治疗。

Comparison the Efficacy of Inhalation and System Application Glucocorticoids in Treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To observe the efficacy and safety of inhalation and system application glucocortieoids in treatment of acute exacerbation of chronic obstructive pulmonary disease, and select the better route of administration. Methods 48 cases in treatment group who system applicated glucocorticoids in the morning, and 51 cases in control group who took the aerosol inhalation with budesonide suspension 2 mg, bid. Observing FEV1, PaO2, PaCO2 and the improvement of dyspnea scores. Mainly observing the effect of controling infection on the safety. Results The improvement of FEV1, PaO2, PaCO2 and the dyspnea score were more significant in treatment group. There was statistical significance in the difference of pre and post treatment （P 〈 0. 05）. There was statistical significance in the no difference on the safety. Conclusion System application of glucocorticoids was the first choice of the patients with acute exacerbation of chronic obstructive pulmonary disease.