雾化布地奈德治疗慢性阻塞性肺疾病急性加重期临床观察

Clinical observation of chronic obstructive pulmonary disease with acute exacerbation of nebulized budesonide

目的比较慢性阻塞性肺疾病急性加重期(AECOPD)吸入布地奈德与静脉滴注甲强龙的临床疗效及卫生经济学。方法回顾性分析山西医科大学第一医院住院的AECOPD患者121例,根据糖皮质激素应用情况分为:布地奈德低剂量组(3 mg/d,A组)33例,布地奈德高剂量组(6 mg/d,B组)32例,甲强龙组(40 mg/d,C组)28例,对照组(未用糖皮质激素,D组)28例,观察各组有效率、血气指标、不良反应、住院天数及费用并进行统计学分析。结果与D组比较,A、B、C组临床总有效率增高,差异均有统计学意义(均P<0.05),各治疗组间比较差异均无统计学意义(均P>0.05)。治疗后血气指标比较,与D组比较,A、B、C组动脉血氧分压(Pa O2)升高,动脉血二氧化碳分压(PCO2)降低;与A组比较,B、C组Pa O2升高,PCO2降低,差异均有统计学意义(均P<0.05);B组与C组比较差异均无统计学意义(均P>0.05)。与C组比较,A、B、D组不良反应降低,差异均有统计学意义(均P<0.05)。与D组比较,A、B、C组的住院天数、费用均减少;与A组比较,B、C组的住院天数、费用均减少,差异均有统计学意义(均P<0.05);B与C组比较差异无统计学意义(P>0.05)。结论 AECOPD吸入布地奈德6 mg/d疗效可靠,糖皮质激素的不良反应发生率低,患者的经济负担轻。

ObjectiveTo compare the curative effect and the health economics of budesonide inhalation and methylprednisolone intravenous in treating acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods121 patients with AECOPD hospitalized patients of the first hospital of Shanxi Medical University were enrolled in this study, according to the application of glucocorticoid hormone, the patients were divided into A group treated with low dose （3 mg/d） budesonide （33 cases）, B group treated with high dose （6 mg/d） budesonide （32 cases）, C group treated with methylprednisolone（40 mg/d, 28 cases） and D group not treated with any glucocorticoids （28 cases）. In the four groups, the patients＇ clinical efficiency, blood gas analysis, adverse reactions, days in hospital and the hospitalization expenses were observed and statistically analyzed.ResultsA, B, C groups of the total clinical efficiency were higher than D group, and the differences were statistically significant （P〈0.05）. There was no statistical significance（P〉0.05） among A, B, C groups. After the treatment of blood gas index, compared with D group, A, B, C groups’ PaO2 increased and PCO2 decreased, all the difference was statistically significant （P〈0.05）. Compared with A group, B, C groups’PaO2 increased and PCO2 decreased, all the difference was statistically significant （P〈0.05）. There was no statistical significance （P〉0.05） between the B, C groups. The adverse reactions of A, B, D groups were lower than C group, and the difference was statistically significant （P〈0.05）. A, B, C groups of days in hospital, and hospitalization expenses were lower than D group, and the differences were statistically significant （P〈0.05）. Compared with A group, days in hospital, hospitalization expenses of B, C groups reduced, and all the difference was statistically significant （P〈0.05）. There was no statistical significance （P〉0.05） between B, C groups. ConclusionThe inhaled budesonide 6 mg/d therapy is effective, and it reduces the side effects, and the economic burden.