足量布地奈德溶液雾化在重度慢性阻塞性肺疾病急性加重期的临床应用

目的：评价足量布地奈德溶液雾化治疗重度慢性阻塞性肺疾病急性加重期患者的临床应用价值。方法：90例30%≤FEV1〈50%的重度COPD急性加重期患者随机分为3组：布地奈德组给予布地奈德溶液雾化吸入2mg/次,每8小时1次;甲泼尼龙组给予口服甲泼尼龙片24mg/次,1/日;对照组不使用任何糖皮质激素。疗程10d,观察3组患者治疗后肺功能,动脉血气和呼吸困难评分变化,以及糖皮质激素主要不良反应。结果：与对照组相比,吸入布地奈德组和口服甲泼尼龙组在FEV1,PaO2,PaCO2和呼吸困难评分改善值方面,有显著差异性（P〈0.05）;吸入布地奈德组和口服甲泼尼龙组两组各项指标改善程度相似（P〉0.05）;吸入布地奈德组和对照组的不良反应少于口服甲泼尼龙组（P〈0.05）。结论：足量布地奈德溶液雾化治疗与口服糖皮质激素疗效相近,全身副作用小,安全性好,是重度COPD急性加重期糖皮质激素的有效选择。

Application of Sufficient Doses of Nebulized Budesonide in the Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease with Severe Airflow Restriction

Objective： To evaluate the clinical application value of nebulized budesonide （NB） on acute exacerbated chronic obstructive pulmonary disease （COPD） with evere airflow restriction. Methods： Ninty patients with acute exacerbations of COPD with severe airflow restriction （30%≤FEVI〈50%） were divided into three groups randomly, inculuding 2 mg NB every 8h;24 mg oral methylprednisolone every day;and the control group didn＇t received any corticosteroid with duration treatment was 10 days, respectively. The lung function, arterial blood gas analysis, dyspnea score and adverse reaction were observed. Results： Compared to control group, there was a significantly greater change in postbronchodilator （支气管扩张剂 SB） FEV1, PaO2, PaCO2 and dyspnea score of two treatment groups （P〈0. 05） ;the difference between NB and methylprednisolone group was no significant （P〉0. 05）;fewer side effects were recorded in NB and control group than in methylprednisolone group （P〈0. 05）. Conclusion.. There was similiary effects between NB and methylprednisolone group. Therefore, sufficant doses of nebulized budesonide with mild generalized side effects and good safety profit maybe an alternative to oral corticosteroid in treating acute exacerbation of COPD.