应用吸入性联合全身激素治疗慢性阻塞性肺病的疗效观察

The Clinical Curative Effect of Combination Inhaled Corticosteroid and Systemic Corticosteroids at acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的：观察慢性阻塞性肺病急性加重期采用吸入性联合全身激素治疗的临床效果。方法：研究选择的对象共90例,均为我院2010年5月~2012年5月收治的慢性阻塞性肺病急性加重期的患者,在使用同等级抗生素及平喘治疗情况下,随机分为观察组（局部联合全身激素治疗）50例和对照组（单纯全身激素治疗）40例。结果：观察组50例中,显效36例,有效12例,无效2例,总有效率为95%;对照组40例中,显效24例,有效10例,无效6例,总有效率为85%。观察组临床总有效率显著高于对照组（P〈0.05）。治疗前观察组和对照组FEV1/L水平、（FEV1/FVC）%水平、PaO2水平、PaCO2水平及血清降钙素原水平均无明显差异,治疗后均有改善,但观察组改善幅度显著优于对照组,差异有统计学意义（P〈0.05）。结论：慢性阻塞性肺病急性加重期采用局部联合全身应用激素治疗,可显著提高临床效果,改善肺功能状况,具有较高的临床应用价值。

Objective：To observe the clinical results on acute exacerbation of chronic obstructive pulmonary disease using combination inhaled corticosteroid and systemic corticosteroids therapy.Methods：This study of 90cases selected objects,all selected from our hospital in May 2010to May 2012,and treated as acute into two groups（local combined with systemic corticosteroids therapy）50patients and the control group（systemic corticosteroids therapy alone）40cases.Results：The 50cases were cured in 36cases,markedly effective in 12cases,effective in 2cases,the total effective rate was 95%control group,40cases were cured in24cases,markedly effective in 10cases,effective in 5cases,invalid in 1case,the total effective ralte was85%.The total effective observtion group was significantly higher（P〈0.05）.Before treatment,the observation group and control group FEV1/L levels,（FEV1/FVC）%levels,PaO2level,PaCO2levels and serum procalctionin levels were not significantly different.After treatment,the improvement in the observation group was significantly better than the control group,the difference was statistically significance（P〈0.05）.Conclusion：Acute exacerbation of chronic obstructive pulmonary disease using systemic corticosteroids combined with local corticosteroids therapy can significantly improve clinical outcomes,improve lung function,with a high clinical value.