糖皮质激素不同给药方式治疗慢性阻塞性肺疾病急性加重期患者的临床研究  

Glucocorticoid administered in different manners for patients with acute exacerbation of chronic obstructive pulmonary disease

作　　者：龚建化[1] 何丽[1] 张家洪[1] 熊邦琴[2] 

机构地区：[1]湖北省荆州市中心医院呼吸内科,434020 [2]湖北省荆州市中心医院护理部,434020

出　　处：《实用医学杂志》2013年第20期3325-3328,共4页The Journal of Practical Medicine

基　　金：荆州市医疗卫生科技发展计划(编号:201119)

摘　　要：目的：观察糖皮质激素不同给药方式治疗慢性阻塞性肺疾病急性加重期（AECOPD）患者的疗效及安全性。方法：根据不同糖皮质激素给药方式将90例AECOPD住院患者随机分为吸入组、静脉组、联合组。观察3组在治疗前，治疗后3d及治疗后7d的BODE评分、血气分析以及不良事件。结果：治疗后3d与治疗前比较，吸入组与联合组的BODE、FEV1％有显著改善（P〈0．01）；治疗后7d与治疗后3d比较。静脉组的BODE、FEV1％以及联合组的FEV。％改善显著（P〈0．01）。3组患者治疗期间总不良事件发生率静脉组〉联合组〉吸入组。结论：激素雾化给药能够更早（0～3d）改善患者气流受限、生活质量．而静脉给药作用时间持久且在激素治疗后期（4～7d）作用更为明显。静脉纽给药副作用发生率高于吸入纽及联合组给药。联合给药可能为治疗AECOPD的最佳选择。Objective To investigate the efficacy and safety of glucocorticoid administered in different manner for patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods Patients hospitalized with AECOPD （n = 90） were randomized into 3 groups： inhalation group, vein group and combined group. The BODE index and adverse event were analyzed, and arterial blood gas analysis was carried out at admission, and 3 d and 7 d after the treatment in all patients. Results BODE index and FEVt%pred were significantly improved at 3 d after the treatment than those at admission in inhalation group and combined group（P 〈 0.01 ） ; While those were improved greatly at 7 d after the treatment than those at 3 d in vein group （P 〈 0.01）, and FEVl%pred was improved remarkably at 7 d than that at 3 d in combined group （P 〈 0.01 ）. The incidence of adverse events was the highest in vein group, and was the lowest in inhalation group. Conclusion Nebulised budesonide could improve the airway obstruction and the quality of life of patients with AECOPD earlier （0 - 3 d）, while systemic corticosteroids got better efficacy in later therapy phase （4 - 7 d）. The incidence of adverse events in vein group was the highest. Combined administration of inhalation with vein was the best choice for treating AECOPD.

关 键 词：肺疾病 慢性阻塞性 急性加重期 糖皮质激素 

分 类 号：R563.9[医药卫生—呼吸系统]