甲基泼尼松龙与吸入性布地奈德混悬液对老年COPD急性加重期患者降钙素原和C反应蛋白水平的影响

Observation of the effect and the influence on PCT,CRP in treatment of elderly patients with acute exacerbation pulmonary disease by budesonide and methyl prednisolone

目的探讨甲基泼尼松龙与吸入性布地奈德混悬液对老年COPD急性加重期患者降钙素原(PCT)和C反应蛋白(CRP)水平的影响。方法将2013~2015年于我院就诊的60岁以上的老年COPD患者86例作为研究对象,按照简单数字表法随机分为观察组和对照组各43例,两组患者除采用常规综合处理外,对照组吸入甲基泼尼松龙,观察组则在对照组治疗基础上加用吸入性布地奈德混悬液联合治疗。治疗7d后,对比两组患者的临床疗效、肺功能指标(FEV1、FEV1/FVC、MIP、MEP)、血气指标(PaO2、PCO2)、血清降钙素原、血清C反应蛋白水平及不良反应发生情况。结果观察组临床总有效率为93.0%,显著高于对照组的69.8%(P<0.05);治疗后两组患者肺功能指标及血气指标均有所改善,与治疗前比较,两组患者PCT及CRP水平均显著降低(P<0.05);对照组中有1例患者出现不良反应,且该组患者治疗后血糖明显升高(P<0.05)。结论吸入性布地奈德混悬液能够显著改善老年COPD急性加重期患者的肺功能,缓解患者病情,且在副作用较低的情况下,调节患者PCT、CRP水平,有效改善预后,具有临床应用价值。

Objective To study methylprednisolone and inhaled budesonide suspension liquid of elderly COPD acute exacerbation in patients with calcitonin and C-reactive protein levels. Methods 86 COPD patients old than 60 years were randomly divided into observation group and control group with 43 cases in each group. The patients were treated with routine comprehensive treatment. The control group was treated with inhaled methyl prednisolone and the observation group with inhalation of budesonide suspension. The clinical efficacy, pulmonary function （FEV1, FEV1/FVC, MIP and MEP）, blood gas indexes （PO2 , pCO2 ） , serum calcitonin）, serum C-reactive protein levels and adverse reactions wet observed. Results The total effective rate of observation group （93%） was significantly higher than that of control group. The indexes of pulmonary function and blood gas of the two groups were improved after treatment. Compared with that before treatment, PCT and CRP of the two group after treatment were significantly reduced （P〈0.05）. In the control group, there were 1 patients with adverse reactions, and the group of patients after treatment was significantly elevated blood glucose （P〈0.05）. Conclusion Inhalation of budesonide suspension can significantly improve lung function in patients with acute exacerbation of chronic obstructive pulmonary disease （COPD）, have few side effects, regulate calcitonin gene-related peptide and C-reactive protein levels and improve the prognosis.