糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的价值

The value of glucocorticoids combined with terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease

目的探究糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期的价值。方法78例慢性阻塞性肺疾病急性加重期患者,按照病床号抓阄分为对照组和研究组,每组39例。对照组患者采用特布他林治疗,研究组患者采用糖皮质激素联合特布他林治疗。比较两组患者临床疗效;治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)和第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)]水平;治疗前后血气指标[动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)]水平。结果研究组患者的治疗总有效率94.9%显著高于对照组的79.5%,差异具有统计学意义(P<0.05)。治疗前,两组患者的FEV1、FVC和FEV1/FVC水平比较,差异无统计学意义(P>0.05);治疗后,两组患者的FEV1、FVC和FEV1/FVC水平均高于本组治疗前,且研究组患者的FEV1、FVC和FEV1/FVC水平均高于对照组,差异均具有统计学意义(P<0.05)。治疗前,研究组患者的PaCO2和PaO2水平分别为(71.1±8.3)、(67.9±7.6)mm Hg(1 mm Hg=0.133 kPa),与对照组的(70.7±8.8)、(67.6±7.9)mm Hg比较,差异无统计学意义(P>0.05);治疗后,研究组患者的PaCO2和PaO2水平分别为(38.6±7.2)、(85.4±8.9)mm Hg,均优于对照组的(44.3±7.6)、(81.3±8.5)mm Hg,且两组患者的PaCO2和PaO2水平均优于本组治疗前,差异具有统计学意义(P<0.05)。结论糖皮质激素联合特布他林治疗慢性阻塞性肺疾病急性加重期能够有效改善患者的肺功能动脉血气指标,缓解临床症状,具有重要的临床价值。

Objective To investigate the value of glucocorticoids combined with terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods A total of 78 patients with acute exacerbation of chronic obstructive pulmonary disease were divided into control group and research group according to the bed number lottery method,with 39 cases in each group.The control group was treated by terbutaline,and the research group was treated by glucocorticoids combined with terbutaline.The clinical efficacy;pulmonary function indexes[forced expiratory volume in the 1st second(FEV1),forced vital capacity(FVC)and FEV1/FVC]before and after treatment;blood gas index[arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2)]before and after treatment were compared between the two groups.Results The total effective rate of treatment 94.9%in the research group was significantly higher than 79.5%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in levels of FEV1,FVC and FEV1/FVC between the two groups(P>0.05).After treatment,the levels of FEV1,FVC and FEV1/FVC in the two groups was higher than those before treatment,and the research group was higher than those in the control group.Their difference was statistically significant(P<0.05).Before treatment,the levels of PaCO2 and PaO2 were(71.1±8.3)and(67.9±7.6)mm Hg(1 mm Hg=0.133 kPa)respectively in the research group,which had no statistically significant difference in(70.7±8.8)and(67.6±7.9)mm Hg in the control group(P>0.05).After treatment,the levels of PaCO2 and PaO2 were(38.6±7.2)and(85.4±8.9)mm Hg respectively,which were all better than(44.3±7.6)and(81.3±8.5)mm Hg in the control group.The levels of PaCO2 and PaO2 in the two groups was better than those before treatment,and their difference was statistically significant(P<0.05).Conclusion Glucocorticoid combined with terbutaline in the treatment of acute exacerbation of chronic obstructive pulmonary disease can effectively improve the pulmonary function and arterial blood gas index of patients,and alleviate clinical symptoms.It contains important clinical value.