沙丁胺醇、溴化异丙托品联合雾化吸入对COPD急性加重期的治疗作用

Effects of nebulizations of salbutamol plus ipratropium bromide on acute exacerbations of chronic obstructive pulmonary disease

目的 探讨联合雾化吸入支气管扩张剂对慢性阻塞性肺疾病(COPD)急性加重期患者肺功能及动脉血气的影响。方法 4 9例COPD患者随机分为对照组(2 3例)和治疗组(2 6例)。两组均予吸氧、抗感染、静脉注射氨茶碱及对症等治疗。治疗组加用溴化异丙托品及沙丁胺醇氧气雾化吸入。两组均于治疗前及治疗7d后测定肺功能及动脉血气。结果 治疗前,两组肺功能及动脉血气无明显差异;治疗后,两组肺功能及动脉血气较治疗前均有明显改善(P <0 .0 1或P <0 .0 5 ) ,治疗组与对照组比较,第1秒用力呼气容积(FEV1 )、FEV1 占用力肺活量(FVC)百分比(FEV1 FVC)、PaO2 和PaCO2 差异有显著性(P值分别为0 .0 4 0、0 .0 2 0、0 .0 1 3和0 .0 0 7) ,FEV1 占预计值百分比及呼气峰流速(PEF)有增高趋势,但差异无显著性(P值分别为0 .0 5 6、0 .0 6 0 )。结论 联合氧气雾化吸入沙丁胺醇和溴化异丙托品对COPD急性加重期患者的肺功能及血气有明显的改善作用。

ObjectiveTo investigate therapeutical effect of nebulization of salbutamol plus ipratropium bromide on acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods 49 patients with COPD were randomly divided into two groups (the treatment group and the control group). The basic regimens for the two groups were oxygen,antibiotics,aminophylline,and the treatment group was given ipratropium bromide and albuterol . All patients underwent pulmonary function test and arterial blood gas analysis before treatment and 7 days after therapy. Results There were significant improvement of all pulmonary function and arterial blood gas relevant parameters of two groups after therapy (P<0.01 or P<0.05).After therapy,FEV_1,FEV_1/FVC,PaO_2 and PaCO_2 were much higher in the treatment group than in the control group,P were 0.040,0.020,0.013 and 0.007,respectively,but percent predicted FEV_1 and PEF showed no significant difference,P were 0.056 and 0.060,respectively). Conclusions Ipratropium bromide and albuterol are superior to the control group on therapeutical effect in acute exacerbations of COPD.