不同种类糖皮质激素对AECOPD临床疗效的比较

Clinical curative effect comparison of different kinds of glucocorticoid treated with AECOPD

目的研究不同种类糖皮质激素对慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效及差异。方法 170例AECOPD患者随机分为5组,泼尼松龙组口服给予泼尼松龙30～40mg/d,氢化可的松、甲泼尼松龙、地塞米松组分别静脉给予氢化可的松(20mg/d)、甲泼尼松龙(40mg/d)、地塞米松(5mg/d)。连用7d。对照组给予常规治疗。统计并比较治疗过程中症状消失时间、总有效率及不良反应发生率。结果与C-G组相比,各糖皮质激素治疗组总有效率均明显高于C-G组(P<0.05),甲泼尼松龙有较高的有效率、较低的不良反应发生率和更短的症状消除时间,其有效率和不良反应发生率分别为91.17%、14.71%。结论糖皮质激素治疗AECOPD宜选择甲泼尼松龙。

Objective To study on clinical curative effect and its differences of different kinds of glucocorticoid treated with AECOPD.Methods 170 patients with AECOPD were randomly divided into 5 groups.Prednisone group was given prednisone（30-40 mg/d） by oral medication.Hydrocortisone,methylprednisolone and dexamethasone groups were injected hydrocortisone（20 mg/d）,methylprednisolone（40 mg/d） and dexamethasone（5 mg/d） by intravenous drip,respectively.Each group was administered for 7 days.Normal therapy was conducted in the control group.The symptoms disappear time,the rate total effective and adverse reactions were counted and compared.Results Compared with the C-G group,the glucocorticoid treatment group total effective rate were significantly higher than that of the C-G group.Methylprednisolone had higher efficient,lower incidence of adverse reactions and shorter eliminate time of symptoms.It’s efficient and incidence of adverse reactions were 91.17% and 14.71%,respectively.Conclusion In the glucocorticoid,methylprednisolone is the most appropriate choice for the treatment of AECOPD.