氧气驱动喷射式雾化吸入布地奈德在慢性阻塞性肺疾病急性加重期治疗中的作用

Effect of supplementary therapy with budesonide on acute exacerbation of COPD

目的研究氧气驱动喷射式雾化吸入糖皮质激素(布地奈德)在慢性阻塞性肺疾病急性加重期(AECOPD)中的治疗作用及临床应用价值。方法选择60例AECOPD住院患者作为研究对象,随机分为布地奈德组、甲基泼尼松龙组和对照组,对照组正规使用沙丁胺醇、特布他林、异丙托溴铵、抗生素等,布地奈德组和甲基泼尼松龙组在此治疗基础上分别联用PARI雾化泵吸入布地奈德或静脉滴注甲基泼尼松龙治疗,3组均同时进行肺功能和动脉血气分析的监测。结果布地奈德组、甲基泼尼松龙组治疗24h、72h及7d后,第1秒用力呼气容积占预计值百分和动脉血氧分压均较对照组显著改善,差异有统计学意义(P<0.05);且布地奈德组、甲基泼尼松龙组间比较无显著差异。结论PARI雾化泵吸入布地奈德可以替代静脉滴注甲基泼尼松龙治疗AECOPD。

ObjectiveTo investigate the clinical effect of supplementary therapy with budesonide on acute exacerbation of chronic obstructive pulmonary disease （COPD）.MethodsSixty patients presenting with acute exacerbation of COPD were randomly divided into three groups. The control group received routine treatment, including nebulized β2agonists, ipratropium bromide, antibiotics, and supplemental oxygen. The budesonide group and the methylprednisolone group received combined therapy of routine treatment and nebulized budesonide or intravenous infusion of methylprednisolone, respectively. All patients underwent the measurement of pulmonary function and arterial blood gas analysis.ResultsThe FEV1% and blood gas parameters were more significantly improved in the budesonide group and methylprednisolone group than those in the control group, while there was no difference in FEV1% and blood gas parameters between budesonide group and methylprednisolone group.ConclusionsNebulized budesonide may be an alternative to systemic corticosteroids in the treatment of acute exacerbations of COPD.