小剂量甲强龙联合呼吸兴奋剂在治疗慢性阻塞性肺疾病合并呼吸衰竭中的疗效评价

Therapeutic effects of low-dose methylprednisolone combined with respiratory stimulants on COPD complicated by respiratory failure

目的分析小剂量甲强龙对慢性阻塞性肺疾病合并呼吸衰竭患者的治疗效果和并发症情况。方法分析2010年3月至2015年10月接收的85例慢性阻塞性肺疾病合并呼吸衰竭患者临床相关资料,根据患者治疗方法不同,分为甲强龙组(40例)和对照组(45例),治疗组为小剂量甲强龙(40 mg)+呼吸兴奋剂(可拉明0.75 mg+洛贝林6 mg),对照组为单纯使用呼吸兴奋剂(可拉明0.75 mg+洛贝林6 mg),分析2组患者心率、呼吸等相关指标。结果 2组患者治疗结束后,心率和呼吸指标、氧分压、二氧化碳分压等血气指标、FEV1/FVC和FEV1占预计值肺功能指标、肺动脉压及C反应蛋白的水平较治疗前均改善,甲强龙组显著优于对照组(P<0.05)。甲强龙组总有效率为92.3%显著高于对照组的74.3%(P<0.05)。结论小剂量甲强龙在慢性阻塞性肺疾病合并呼吸衰竭患者的治疗中疗效显著,主要体现在其对患者的心率和呼吸指标的改善,血气和肺功能、肺动力水平的提高,C反应蛋白水平的降低,对于无禁忌证的慢性阻塞性肺疾病患者来说,甲强龙在治疗中值得推荐应用。

Objective To observe therapeutic effects of low-dose methylprednisolone combined with respiratory stimulants on chronic obstructive pulmonary disease（ COPD） complicated by respiratory failure. Methods The clinical data about 85 patients with COPD complicated by respiratory failure who were admitted and treated in our hospital from March 2010 to October 2015 were retrospectively analyzed. According to different therapy methods,the patients were divided into methylprednisolone group（ n = 40） and control group（ n = 45）. The patients in methylprednisolone group were treated by low-dose methylprednisolone（ 40mg） ＋ respiratory stimulants（ cortvodon 0. 75 mg ＋ lobeline 6mg）,however,the patients in control group were treated by respiratory stimulants only（ cortvodon 0. 75 mg ＋ lobeline 6mg）,the related indexes including heart rate,blood gas indexes,parameters about lung function were analyzed and compared between two groups. Results As compared with those before treatment,the heart rate,respiration indexes,PaO_2,PaCO_2,FEV1 /FVC,FEV1 of expected value,pulmonary artery pressure and C-reactive protein levels in both groups were improved after treatment,moreover,methylprednisolone group was superior to control group（ P 0. 05）. Meanwhile the total effective rate（ 92. 3%） in methylprednisolone group was significantly higher than that（ 74. 3%） in control group（ P 0. 05）. Conclusion The low-dose methylprednisolone has obvious therapeutic effects on COPD complicated by respiratory failure,which can improve patient＇s heart rate,respiration indexes,blood gas parameters and lung function,and can decrease C-reactive protein levels,thus,which is worth using widely in clinical practice.