吸入二丙酸倍氯米松治疗稳定期慢性阻塞性肺疾病的疗效

High-dose Inhaled Beclomethasone Dipropionate and Maximal Improvements in Patients with Stable Chronic Obstructive Pulmonary Disease

目的探讨吸入大剂量二丙酸倍氯米松治疗稳定期慢性阻塞性肺疾病(COPD)的疗效。方法42例持续吸入1600μg/d二丙酸倍氯米松的稳定期COPD患者口服强的松30mg/d3周,利用随机分组、双盲、安慰剂对照及交叉设计的方法研究其疗效。观察指标包括支气管扩张剂吸入前后的一秒钟用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰流速(PEFR)、症状评分及生活质量(HRQL)。结果口服强的松在改善FEV1、FVC、PEFR、症状及HRQL等方面均没有显著性意义。结论吸入1600μg/d二丙酸倍氯米松的稳定期COPD患者已经获得了糖皮质激素治疗的最大疗效。

Objective To determine the therapeutic effectiveness of persistantly inhaled beclomethasone dipropionate （BDP） in the treatment of the patients with chronic obstructive pulmonary disease （COPD） . Methods A randomized, doubleblind, placebo controlled, cross over trial was performed on 42 patients with stable COPD treated with both inhaled bronchodilators and 1600μg of BDP daily for at least 3 months. Each patient received 30mg of oral prednisolone or a placebo for 3 weeks. In addition to end-point spirometric assessments, daily peak expiratory flow rate, symptom scores, and scores on a chronic respiratory disease questionnaire were recorded for the last week of each 3-week period. Results Oral prednisolone did not improve FEV1, FVC, PEFR. symptoms or scores on the questionnaire. Conclusion 1600μg of BDP in addition to inhaled bronehodilators produces maximal improvements in stable patients with COPD.