雾化吸入布地奈德与口服泼尼松治疗慢性阻塞性肺疾病急性加重期患者的疗效及炎性因子表达对比研究

A Comparative Study on the Efficacy of Aerosolized Budesonide and Oral Prednisone in Treatment of AECOPD and Expression of Inflammatory Factors

目的探讨雾化吸入布地奈德与口服泼尼松治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的疗效及炎性因子的表达。方法选择我院住院治疗的AECOPD患者102例,随机分为观察组与对照组各51例,观察组予口服泼尼松治疗,对照组予雾化吸入布地奈德治疗,共7天,观察治疗前后两组的疗效及血清炎性因子表达。结果治疗后两组患者肺功能第一秒用力呼气量(FEV1%)、慢性阻塞性肺病评估测试(CAT)评分及超敏C反应蛋白(hs-CRP)均有明显改善,差异有统计学意义(P<0.05);与对照组比较,观察组呼出气一氧化氮(FeNO)和动脉氧分压(PaO2)水平均显著改善,差异有统计学意义(P<0.05)。观察组白介素-8(IL-8)、肿瘤坏死因子(TNF-α)水平明显降低,差异有统计学意义(P<0.05),而对照组IL-8水平与治疗前相比无明显变化。平均住院天数观察组明显少于对照组,但两组在出院30天内急性加重人数及再住院人数无明显差异。结论口服泼尼松与雾化吸入布地奈德治疗AECOPD比较,其临床疗效更佳,控制炎症更有效。

Objective To investigate the efficacy of aerosolized budesonide and oral prednisone in treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and expression of inflammatory factors.Methods 102 patients with AECOPD hospitalized in our hospital were randomly divided into the observation group and the control group,including 51 cases in each group.The observation group was treated with oral prednisonefor 7 days,while the control group was treated with aerosolized budesonide for 7 days.The efficacy and expression of serum inflammatory factorsin the two groups before and after treatment were observed.Results After treatment,measured value of the first second Forced expiratory volume as a percentage of predicted value(FEV1%),chronic obstructive pulmonary disease assessment test(CAT)score,and level of high-sensitivity C-reactive protein(hs-CRP)were significantly improved in both groups,and the differences were statistically significant(P<0.05);Compared with the control group,exhaled nitric oxide(Fe NO)and level of arterial oxygen partial pressure(PaO2)in the observation group were significantly improved,and the differences were statistically significant(P<0.05).Levels of interleukin-8(IL-8)and tumor necrosis factor(TNF-α)in the observation group were significantly lower(P<0.05),while level of IL-8 in the control group was not significantly different from that of before treatment.The average hospital duration was significantly lower in the observation group than that in the control group,but there was no statistically significant difference in the number of acute exacerbationand rehospitalization between the two groups within 30 days after discharge.Conclusion Oral prednisone is more effective than aerosolized budesonide in treatment and in controlling inflammation of AECOPD.