不同初始剂量甲泼尼龙对慢性阻塞性肺疾病急性发作期治疗的影响

Effect of Different Starting Dose Methylprednisolone on Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

目的探讨不同初始剂量甲泼尼龙在慢性阻塞性肺疾病(COPD)急性加重期的近期疗效和安全性。方法将40例COPD患者随机分成两组,A组(20例)予初始剂量甲泼尼龙120mg/d,B组(20例)予甲泼尼龙80mg/d,逐渐减量,观察临床疗效,分别于入院时和治疗后第72h、第7天做动脉血气分析、呼吸困难评分,第7天测血糖和肝肾功能。结果A组72h疗效和血气改善情况明显优于B组,无1例出现上消化道出血和两重感染,血糖和肝肾功能均在正常范围。结论120mg/d初始剂量的甲泼尼龙在慢性阻塞性肺疾病急性加重期治疗早期疗效更显著,未见不良反应,值得推广应用。

Objective To evaluate effects of different starting dose methylprednisolone on acute exacerbations of chronic obstructive pulmonary disease（AECOPD）. Methods 40 patients with AECOPD were allocated two groups in random, including group A（n = 20, 120mg methylprednisolone）and groups B（n = 20,80mg methylprednisolone） , with duration of treatment was 7 days respectively. Clinical sign and symptom, dyspnea score and arterial blood gases were measured and observed at 0 - hour,72 - hour, day 7. Results The group A was surperior to the group B in clinical efficacy . The differences of dyspnea score and arterial blood gases at 72 - hour are significant between the two groups （P 〈 0.05）. Conclusions 120 mg starting dose of methylprednisolone has good curative effects on early stages of AECOPD.