不同剂量布地奈德雾化吸入和泼尼松龙静脉用药治疗AECOPD的对比研究  

Effects of different dosing regiments of inhaled budesonide suspension and vein methylprednisolone on acute exacerbations of COPD

作　　者：钱朝霞[1] 何艳[1] 方陈[1] 方涛[1] 高忠和[1] 

机构地区：[1]蚌埠市第三人民医院呼吸科,安徽蚌埠233000

出　　处：《临床肺科杂志》2010年第4期488-490,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨不同剂量布地奈德雾化吸入对比静脉用泼尼松龙治疗慢性阻塞性肺病急性加重期(AECOPD)的临床疗效和安全性。方法92例AECOPD患者随机分为布地奈德1组(24)、布地奈德2组(25)、泼尼松龙组(22)和对照组(21),分别给予布地奈德1 mg/次(1次/8 h)、2 mg/次(1次/8 h)和泼尼松龙静点40 mg/次(1次/q12 h),其他治疗相同。记录治疗后第3、5、7、10天临床症状评分和FEV1/预计值、PaO2、PaCO2、副反应和血糖情况。结果①治疗后5、10天布地奈德组1组、2组、泼尼松龙组临床症状评分明显下降,和对照组比较有统计学意义(P<0.05),布地奈德2组、泼尼松龙组和布地奈德1组间差异有统计学意义(P<0.05)。②治疗后第5天布地奈德1组、2组和泼尼松龙组的FEV1和动脉血气(PaO2、PaCO2)改善程度均明显优于对照组(P<0.05),布地奈德2组较1组FEV1增加(P<0.05)。直至观察终点布地奈德Ⅱ组的PaO2增加较Ⅰ组和对照组更显著。③短期副反应布地奈德1、2组主要为声嘶,泼尼松龙组为血糖升高。④前三组患者的住院时间之间没有统计学差异(P>0.05),但较对照组明显缩短(P<0.05)。结论布地奈德雾化吸入能明显改善AECOPD患者肺功能,提高患者生活质量,其疗效与泼尼松龙一致,但全身副作用较轻;布地奈德6 mg组较布地奈德3 mg组症状及肺功能改善更快更好。Objective To evaluate the effects and safety of different dosing regimens of inhaled budesonide （BUD） suspension and vein methylprednisolone on acute exacerbations of COPD. Methods Ninety-two subjects with moderate to severe AECOPD were divided into three groups ： group 1 ： （24）, group 2 ： （25）, group methylprednisolone （ n = 22 ） and placebo group（ n = 21 ）. Group 1 and group 2 received BUD 1 mg or 2 mg inhalation every time,q8 h;The third group received methylprednisolone 40 mg every time q12 h,other treatments were same. The clinic score, lung function （ FEV1% ）, blood gas ananysis （ PaO2, PaCO2 ）, adverse effects and blood glucose after 3, 5,7,10 days were recorded. Results In 5 and 10 days after the treatment, the dyspnea score of group 1,2 and methylprednisolone descented obviously（ P 〈 0.01 ） ; In 5 days after treatment, FEVl and PaO2 , PaCO2 of group 1,2 and methylprednisolone improved obviously（P 〈 0. 05 ） ,the increase of PaO2 and FEV1 was more obvious in group 2 than group 1 and placebo until the end point of the observation;The short-term adverse effect was hoarseness in group 1 and 2 ,high blood glucose in group methylprednisolone;The hospital stay in group 1,2 and methylprednisolone was shorter obviously （ P 〈 0. 05 ）. Conclusion Inhaled BUD suspension can improve more significantly and quickly the lung functions and the quality of life of patients with AECOPD, especially in patients receiving BUD 2 rag, q8 h;Its curative effects are as effective as methylprednisolone and the adverse reactions are lighter.

关 键 词：慢性阻塞性肺病 急性加重期 布地奈德 泼尼松龙 

分 类 号：R563.9[医药卫生—呼吸系统]