甲泼尼龙与特布他林联用在COPD治疗中的作用

Treatment of Acute Exacerbations of COPD by Intravenous Methylprednisolone Combined with Nebulized Terbutaline Sulphate

目的 :观察静脉注射甲泼尼龙与短效β2 受体激动剂特布他林雾化吸入联用对慢性阻塞性肺疾病 (COPD)急性加重期的治疗作用。方法 :49例 COPD急性加重期患者随机分为治疗组 (2 5例 ) ,给予静脉注射甲泼尼龙 80 mg/次 ,3次 /d,连续 3d后改用布地奈德干粉剂 (DPI) 1 2 0 0 μg/ d吸入 ,对照组 (2 4例 )给予布地奈德 (DPI) 1 2 0 0 μg/ d吸入 ,两组均联用特布他林雾化溶液 ,每次 5mg,2次 / d。每日测 FEV1 、PEF,连续观察 5d。结果 :治疗组 FEV1 值从治疗前 (0 .69±0 .1 8) L上升到 (1 .0 6± 0 .32 ) L(P<0 .0 1 ) ,PEF值从 (1 .46± 0 .54) L/ s上升到 (2 .88± 0 .47) L/ s(P<0 .0 1 ) ,FEV1 值及 FEV1 增加量 >2 0 0 ml的病例数均高于对照组。结论 :静脉注射甲泼尼龙与短效 β2

Objective: To investigate the improvement of pulmonary function by intravenous methylprednisolone combined with terbutaline solution for nebulization in severe exacerbation of COPD.Methods:49 patients were randomly divided into two groups. 25 cases in treatment group were administrated with intravenous methylprednisolone 240mg/day for three days,followed by budesonide dry powder inhaled (1200μg/day).Control group received inhaled budesonide 1200μg/day.Two groups were all given terbutaline by nebulization in a dose of 5mg,twice a day. FEV 1?PEF were determined on day 1 to day 5.Results: In treatment group, there were significantly increased in FEV 1 and PEF,from 0.69±0 18 L to 1 06±0 32L,and from 1 46±0 54L/s to 2 88±0 47L/s, respectively( P <0 01).FEV 1 and the positive rate of improvement in FEV 1>200ml were significantly higher in treatment group than that in control group. Conclusion: The improvement of pulmonary function by intravenous methylprednisolone is more rapid than inhaled budesonide in severe exacerbation of COPD.