大剂量甲泼尼龙在慢性阻塞性肺疾病并2型呼吸衰竭中的应用

Application of Methylprednisolone at Large Dosage to Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure Type Ⅱ

目的探讨甲泼尼龙在抢救慢性阻塞性肺疾病并2型呼吸衰竭肺性脑病时的疗效。方法49例随机分为甲泼尼龙治疗组(23例),地塞米松治疗组(26例)。7d内,分别给予甲泼尼龙,地塞米松两种药物治疗,各组患者常规应用抗生素、氧疗、拟肾上腺素、茶碱类药物、呼吸兴奋剂、化痰药,并纠正酸碱电解质和水平衡。结果甲泼尼龙治疗组的总有效率(95.6%)显著高于地塞米松治疗组(80.7%),尤其在肺性脑病患者的抢救治疗上,疗效更为显著,其显效率高达52.2%(地塞米松治疗组38.5%)。结论与地塞米松相比,甲泼尼龙减轻症状及控制病情、缓解喘咳症状更为显著,较少有毒副作用,是治疗慢性阻塞性肺疾病并2型呼吸衰竭肺性脑病危重症较理想的皮质激素。

Objective To discuss the therapeutic effect of methylprednisolone on chronic obstructive pulmonary disease complicated with pulmonary encephalopathy due to respiratory failure type Ⅱ.Methods Forty-nine patients were divided into methylprednisolone group (23) and dexamethasone group (26) at random. In addition to routine treatments such as antibiotics and oxygen support, the two groups were respectively administered with methylprednisolone and dexamethasone within seven days. Results The effective rate of methylprednisolone group was 95.6%, significantly higher than that of dexamethasone group (80.7%). Methylprednisolone's effect was more significant when it was used in the emergent treatment of pulmonary encephalopathy, whose effective rate rose up to 52.2% (higher than 38.5% of dexamethasone group). Conclusion As a cortical hormone used in the treatment of chronic obstructive pulmonary disease complicated with pulmonary encephalopathy due to respiratory failure type Ⅱ, methylprednisolone gains an advantage over dexamethasone when they are compared in the application to relieving symptoms and controlling state.