雾化吸入和口服糖皮质激素治疗慢性阻塞性肺疾病急性加重期的效果分析

Effect analysis of aerosol inhalation and oral corticosteroids on acute exacerbation of chronic obstructive pulmonary disease

目的探讨雾化吸入和口服糖皮质激素治疗慢性阻塞性肺疾病急性加重期(AECOPD)的效果。方法将重庆市第五人民医院2009年4月至2011年4月收治的83例慢性阻塞性肺疾病急性加重期患者随机分为雾化组(雾化吸入布地奈德混悬液治疗)和口服组(口服泼尼松治疗);回顾分析患者的临床资料:①两组治疗前、治疗后3 d、7 d和14 d的肺功能指标(FEV1、FEV1/FVC、FEV1占预计值比例和PEF)、血气分析(血PaO2、PaCO2和pH)及症状得分情况,并计算治疗后各时间点相对于治疗前各指标的改善情况;②治疗过程中的不良反应。结果两组治疗后7 d和14 d的肺功能指标、血气分析和症状得分均优于治疗前;雾化组治疗后3 d的以上指标优于治疗前和口服组,治疗后3 d的改善值大于口服组,其余时间点与口服组无差异;雾化组的不良反应发生率低于口服组(P<0.01)。结论雾化吸入治疗可快速缓解慢性阻塞性肺疾病急性加重期症状,但后期治疗效果与口服组相当,且不良反应少,可推广使用。

Objective To explore the effects of aerosol inhaled and oral corticosteroids on the acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Totally 83 patients with AECOPD admitted by our hospital from April 2009 to April 2011 were randomly divided into Atomization group（ aerosol inhalation budesonide treatment） and Oral Group （ oral prednisone）. The clinical data of the patients was retrospective analyzed ： Pulmonary function （FEV1, FEV1/FVC ratio, FEV1 percentage of predicted value ratio and PEF）, blood gas analysis（ blood Pa02, PaCO2 and pH） and Symptom score before treatment, 3rd d, 7th d and 14th d after treatment, as well as the improvement of the above indices at different time points after treatment compared to before treatment ; Adverse reactions during the treat- ment. Results The pulmonary function, blood gas analysis, and symptom scores of 7th d and 14th d after treatment were better than before; The above indices of Atomization group 3rd d after treatment were better than before and Oral group, and the rest time with no difference ; The incidence of adverse reactions of Atomization group is lower than the oral group （P 〈 0. 01 ）. Conclusions Inhalation therapy can quickly relieve the symptoms of the acute exacerbation of chronic obstructive pulmonary disease, while the effects of post - treatment were similar with the oral group. The adverse reactions of inhalation therapy were lower, which can be promoted clinically.