摘要
目的 观察布地奈德溶液雾化治疗对伴有严重气流受限的慢性阻塞性肺疾病 (COPD)急性加重期患者的影响。方法 6 0例 1秒钟用力呼气量 (FEV1) <1L/min的重度COPD急性加重期住院患者随机均分为3组 :布地奈德组给予布地奈德雾化液雾化吸入 2mg/次 ,每 8小时 1次 ;泼尼松组给予口服泼尼松片 10mg/次 ,每日 3次 ;空白对照组不使用任何糖皮质激素。观察 3组患者治疗后呼吸困难评分、肺功能和动脉血气变化。结果 治疗后 2 4h ,布地奈德组、泼尼松组和空白对照组的呼吸困难评分别下降 (1.8± 0 .7)、(2 .0± 0 .8)和 (1.3± 0 .7)分 ,FEV1分别上升 (0 .13± 0 .0 9)、(0 .14± 0 .0 8)和 (0 .0 8± 0 .0 5 )L ,二氧化碳分压 (PaCO2 )分别下降 (4.1± 2 .8)、(3.9± 2 .9)和 (2 .1± 2 .6 )mmHg(1mmHg =0 .133kPa) ,氧分压 (PaO2 )分别升高 (5 .2± 4 .5 )、(7.0± 4 .3)和 (4.1± 4 .7)mmHg ;治疗后 72h ,呼吸困难评分分别下降 (2 .5± 1.1)、(2 .6± 1.1)和 (1.7± 1.2 )分 ,FEV1分别上升 (0 .2 0± 0 .11)、(0 .18± 0 .10 )和 (0 .12± 0 .0 9)L ,PaCO2 分别下降 (7.1± 3.4 )、(7.5± 3.6 )和(3.9± 4 .0 )mmHg ,PaO2 分别升高 (6 .1± 4 .2 )、(8.3± 4 .7)和 (5 .2± 4 .5 )mmHg ;治疗后第 7天 ,呼吸困?
Objective To evaluate the effect of Nebulized Budesonide(NB)on chronic obstructive pulmonary disease (COPD) with severe restriction of airflow.Methods 60 patients with acute exacerbations of COPD were allocated into 3 groups in random, including 2 mg NB every 12 h (n=20), 30 mg oral prednisone every day(n=20), and the blank control group did not receive any corticosteroid (n=20) with duration of treatment was 7 days, respectively. The postbronchodilator FEV 1, the dyspnea score and arterial blood gases were measured and observed at 0-hour (H0), 24-hour (D1), 72-hour (D3), day 7(D7).Results The dyspnea score from H0 to D1 in the 3 groups were 1.8 ±0.7 (NB), 2.0±0.8 (prednisone), 1.3±0.7 (control), respectively. Those from H0 to D3 was 2.5±1.1, 2.6 ±1.1, 1.7±1.2; and from H0 to D7 2.8±1.1, 3.0±1.2, 2.3±1.40, respectively. The postbronchodilator FEV 1 from H0 to D1 in the 3 groups showed as (0.13±0.09) L, (0.14±0.08) L, (0.08±0.05) L; from H0 to D3 (0.2±0.11) L, (0.18 ±0.1) L, (0.12±0.09) L, and from H0 to D7 (0.24±0.12) L as (0.25±0.13) L, (0.2±0.11) L, respectively. The values of PaCO 2 from H0 to D1 in the 3 groups was (4.1±2.8) mm Hg, (3.9 ±2.9) mm Hg, (2.1±2.6) mm Hg; from H0 to D3 were (7.1±3.4) mm Hg, (7.5±3.6) mm Hg, (3.9 ±4.0) mm Hg,and from H0 to D7 were (8.0±3.1) mm Hg, (8.5±4.0) mm Hg, (6.2±4.1) mm Hg, respectively. The values of PaO 2 from H0 to D1 in the 3 groups were ( 5.2±4.5) mm Hg,(7.0±4.3) mm Hg, ( 4.1 ±4.7) mm Hg; from H0 to D3 were (6.1±4.2) mm Hg, (8.3±4.7) mm Hg,( 5.2±4.5) mm Hg, and from H0 to D7 were (7.2±4.3) mm Hg, (9.1±4.5) mm Hg, (7.0±4.4) mm Hg, respectively.Conclusion The outcome of NB group is better than that of the control, but the difference between NB group and the prenisolone group was not significant. NB may be an alternative to oral prednisone in the treatment of exacerbations of COPD.
出处
《上海医学》
CAS
CSCD
北大核心
2004年第12期882-884,共3页
Shanghai Medical Journal
