异丙托溴铵、沙丁胺醇雾化吸入联合甲泼尼龙治疗慢性阻塞性肺病急性加重期的临床观察

Clinical observation of ipratropium bromide,salbutamol for atomization inhalation combined with methylprednisolone treating chronic obstructive pulmonary disease in an acute exacerbation period

目的探讨异丙托溴铵、沙丁胺醇雾化吸入联合静脉注射甲泼尼龙治疗慢性阻塞性肺病(COPD)急性加重期的临床效果。方法将60例COPD急性加重期患者随机分为对照组和治疗组,每组各30例。治疗组雾化吸入0.9%的氯化钠溶液2 ml+异丙托溴铵500μg、沙丁胺醇2500μg,2次/d,甲泼尼龙40 mg静脉注射,1次/d;对照组仅给甲泼尼龙40 mg静脉注射,1次/d。比较两组的肺功能、血气分析变化及临床疗效。结果治疗组的总有效率为93.3%,高于对照组的83.3%(P<0.05);治疗后,两组的FEV1、FEV1/FVC、PaO2较治疗前显著上升,PaCO2较治疗前显著下降,且治疗组的上述各指标改善情况均优于对照组(P<0.05)。结论异丙托溴铵、沙丁胺醇雾化吸入联合静脉注射甲泼尼龙治疗COPD急性加重期的效果好,可较快改善患者的肺功能及PaO2、PaCO2。

Objective To investigate clinical effect of ipratropium bromide,salbutamol for atomization inhalation com- bined with methylprednisolone treating chronic obstructive pulmonary disease （COPD） in an acute exacerbation period. Methods 60 patients with COPD in an acute exacerbation period were randomly divided into the control group of 30 patients and the treatment group of 30 patients.The treatment group was treated with 0.9% sodium chloride solution of 2 ml, ipratropium bromide 500 g and salbutamol 2500 g for atomization inhalation,2 times every day,intravenous methylprednisolone 40 rag,1 time every day;the control group was only treated with intravenous methylprednisolone 40 mg, l time every day.Lung function,change of blood gas analysis and clinical curative effect of tlae two groups were compared. Results The total effective rate （93.3%） in the treatment group was higher than that in the control group （83.3%） （P 〈O.05）;after treatment,FEV ,FEVI/FVC,PaO2 were increased significantly and PaCO were decreased signifi- cantly of the two groups compared with before treatment and the improvement of the indicators above-mentioned in the treatment group was better than that in the control group （P〈0.05）. Conclusion The effect of ipratropium bromide, salbutamol for atomization inhalation combined intravenous methylprednisolone treating COPD in acute exacerbation period,and it can rapidly improve lung function and PaO2 and PaCO2 of patients.