慢性阻塞性肺疾病急性加重期甲泼尼松龙与布地奈德疗效观察

Effects of Methylprednisolone and Budesonide on Acute Exacerbations of Chronic Obstructive Pulmonary Disease

目的:比较雾化吸入布地奈德与静滴甲泼尼松龙在慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及安全性。方法:将98例AECOPD的住院患者随机分为布地奈德组、甲泼尼松龙组和对照组,观察3组患者在用药后1d、3d、7d的呼吸困难分级、肺功能、动脉血氧分压(PaO2)及不良反应。结果:甲泼尼松龙组在治疗后1d、3d改善呼吸困难、肺功能、PaO2优于布地奈德组和对照组,有显著性差异(P<0.05)。甲泼尼松龙组和布地奈德组治疗第7天改善呼吸困难、肺通气功能、PaO2优于对照组,有显著性差异(P<0.05)。结论:在有力的抗感染、使用支气管扩张剂的基础上,AECOPD短期、适量使用全身糖皮质激素和雾化吸入布地奈德治疗均可加速患者的恢复,改善肺功能和低氧血症。对重症AECOPD尽早使用全身糖皮质激素可改善预后,降低死亡率。

Objective：To evaluate the efficacy and safety of nebulized hudesonide（NB） and intravenous methylprednisolone（IVM） on acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods： 98 inpatients with AECOPD were randomly divided into three groups, including NB group （n= 30）, IVM group（n= 30）and the control group（n=38）. The dyspnea score , lung function , arterial blood oxygen pressure（PaO2 ）and side-effects were observed at 1-day,3-day, 7-day. Results： The dyspnea score, lung function and PaO2 in IVM were significantly improved compared to the control and NB groups（P〈0. 05）at day 1 and day 3. The outcomes of IVM and NB groups were better than that of the control group（P〈0. 05） at day 7. Conclusion：On the basis of antibiotics and bronchod-ilators,in early stage of severe AECOPD, short duration use of systemic steroids and NB can boost recovery, improve lung function and hypoxia, decrease mortality.