甲羟孕酮在低体质量慢性阻塞性肺疾病急性加重期患者中应用的疗效评价

Evaluation of the effect of medroxyprogesterone acetate in patients with acute exacerbation of chronic obstructive pulmonary disease and low body mass index

目的探讨甲羟孕酮在低体质量慢性阻塞性肺疾病急性加重期(AECOPD)患者中的疗效。方法将60例低体质量AECOPD患者随机分为2组,研究组30例,对照组30例。2组均予以抗感染、吸氧、解痉、平喘、化痰、纠正酸碱失衡及电解质紊乱等综合治疗。研究组给予甲羟孕酮0.5 mg,一次/d口服,疗程10 d。在研究前1 d、研究后10 d分别对两组患者进行血气分析指标、血脂、血清白蛋白水平测定。记录2组患者住院时间及住院总费用。结果治疗后研究组和对照组患者p H值(7.42±0.05 vs.7.35±0.05)、氧分压(74.83±7.19 vs.68.10±8.19)mm Hg、二氧化碳分压(55.57±6.94 vs.61.60±8.32)mm Hg、总胆固醇(3.67±0.34 vs.3.52±0.36)mmol/L、甘油三酯(1.49±0.49 vs.1.27±0.46)mmol/L、白蛋白(30.44±3.04 vs.26.27±1.83)g/L。研究组患者的血气指标、血脂及血清白蛋白水平较对照组患者有较明显改善(P<0.05),研究组患者住院时间[(12.20±2.86)d]缩短,住院费用[(9 031.41±2 457.67)元]减少,与对照组患者相比有显著性差异(P<0.05)。结论甲羟孕酮可改善低体质量AECOPD患者的食欲、增加进食量、改善肺通气、促进病情恢复。

Objective To evaluate the effect of medroxyprogesterone acetate in patients with acute exacerbation of chronic obstructive pulmonary disease and low body mass index. Methods Sixty patients with acute exacerbation of chronic obstructive pulmonary disease and low body mass index were randomly divided into treatment group （ n = 30）, and control group （ n = 30 ）. All patients were given synthesis management. The treatment group was administrated with oral medroxyprogesterone acetate. Parameters of blood gas analysis, blood lipid and blood albumin were measured 1 d before treatment and 10 d after treatment, and hospitalization days, total cost of hospitalization were recorded in each group. Results After treatment, in treatment group and the control group pH （7.42±0.05 vs. 7.35 ±0.05 ）, and oxygen partial pressure （74.83±7.19 vs. 68.10±8.19） mmHg, CO2 partial pressure （55.57±6.94 vs. 61.60±8.32） mmHg, total cholesterol （3.67±0.34 vs. 3.52±0.36） mmol/L, triglycerides （1.49±0.49 vs. 1.27±0.46） mmol/L, albumin （30.44±3.04 vs. 26.27±1.83） g/L. Ten days after oral medroxyprogesterone acetate treatment, the parameters of blood gas analysis, blood lipid and blood albumin in treatment group were significantly improved compared with those of control group（P〈0.05）. The hospitalization days [ （12.20±2.86）dl and total cost of hospitalization [ （9 031.41 ± 2 457.67）yuan ] in treatment group were significantly lower than those of control group（P〈0.05）. Conclusion Medroxyprogesterone acetate can improve the appetite of patients with acute exacerbation of chronic obstructive pulmonary disease and low body mass index and promote rehabilitation.