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 on the efficacy of budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的：探讨布地奈德治疗慢性阻塞性肺疾病急性加重期（AECOPD）临床效果。方法：分析2015年1月～2016年1月我院收治的60例中重度AECOPD患者的临床资料，随机分为试验组与对照组；两组均常规给予吸氧、抗感染、化痰等治疗，并采用异丙托溴铵0．5mg／次、硫酸沙丁胺醇雾化溶液2．5mg／次，3次／d，20min／次雾化吸入，试验组给予布地奈德2mg／次，对照组布地奈德1mg／次，每8h一次雾化吸入，两组均连续治疗7d；测定治疗前后动脉氧分压（PaO2）、二氧化碳分压（PaCO2）、第一秒用力呼气容积（FEV1）、FEV1／用力肺活量（FVC）变化，并进行疗效评价。结果：治疗后两组PaO2、PaC0z较治疗前均改善（P〈0．05），观察组优于对照组，有统计学意义（P〈0．05）；治疗后两组FEV1、FEV1／FVC较治疗前均改善（P〈0．05），观察组优于对照组，有统计学意义（P〈0．05）；观察组总有效率为93．33％，对照组为76．67％，有统计学意义（P〈0．05）。结论：对AECOPD患者可以采用布地奈德雾化吸入进行治疗，短期较大剂量吸入能够明显改善患者血气及肺功能。

Objective.. To explore the clinical efficacy of budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods： A total of 60 patients with moderate and severe AECOPD who were admitted in our hospital from January, 2015 to January, 2016 were included in the study and randomized into the experiment group and the control group. The patients in the two groups were given oxygen inhalation, anti-infection, phlegm dispersing, ipratropium bromide （0.5 mg/time）, and aerosol liquid of salbutamol sulfate （2.5 mg/time）, 3 times/d, 20 min/time, aerosol inhalation. The patients in the experiment group were given budesonide （2 mg/time）, while the patients in the control group were given budesonide （1 mg/time）, every 8 h for one aerosol inhalation. The patients in the two groups were continuously treated for 7d. The changes of PaO2, PaCOz, FEV1, and FEV1/FVC before and after treatment were detected, and the effica- cy was evaluated. Results： After treatment, PaOz and PaCO2 in the two groups were significantly improved when compared with before treatment （P〈0.05）, and the improved degree in the observation group was significantly superior to that in the control group （P〈0.05）. After treatment, FEV1 and FEV1/FVC in the two groups were significantly improved when compared with before treatment （P〈0.05）, and the improved degree in the observation group was significantly superior to that in the control group （P〈0.05）. The total effective rate in the observation group （93.33 %） was significantly higher than that in the control group （76.67%） （P〈0.05）. Conclusions： Aerosol inhalation of budesonide in the treatment of AECOPD in a large dose for a short term can significantly improve the blood gas and pulmonary function.