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不同剂量布地奈德联合异丙托溴铵对AECOPD患者主观症状、肺功能及动脉血气指标的影响
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| 篇名： | 不同剂量布地奈德联合异丙托溴铵对AECOPD患者主观症状、肺功能及动脉血气指标的影响 |
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| 摘要： | 目的：探讨不同剂量布地奈德联合异丙托溴铵对慢性阻塞性肺疾病急性加重（AECOPD）患者主观症状、肺功能及动脉血气指标的影响及安全性。方法：选择AECOPD住院患者183例，按随机数字表法将患者分为低、中、高剂量组，各61例。3组患者均采用常规治疗，异丙托溴铵500 μg+0.9％氯化钠注射液（NS）2 ml氧动力驱动雾化吸入，氧气流量4～5 L/min，15～20 min/次，tid。低、中、高剂量组患者在常规治疗的基础上分别吸入用布地奈德混悬液0.5、1.0、2.0 mg+NS 2 ml氧动力驱动雾化吸入，氧气流量4～5 L/min，20 min/次，bid。3组患者均治疗7 d。比较3组患者治疗前及治疗后3、7 d的肺功能、呼吸困难分级（MRC）量表评分、动脉血气指标和不良反应发生情况。结果：3组患者治疗后第一秒用力呼气容积（FEV1％）均有明显改善，且治疗后3、7 d，3组患者FEV1％高剂量组＞中剂量组＞低剂量组，组间比较差异均有统计学意义（P＜0.05）。3组患者治疗后MRC量表评分均明显下降；且治疗后3 d，MRC量表评分高剂量组＜中剂量组＜低剂量组；治疗后7 d，中剂量组和高剂量组患者明显低于低剂量组，差异均有统计学意义（P＜0.05）；但高、中剂量组患者MRC量表评分比较，差异无统计学意义（P＞0.05）。治疗后，3组患者动脉血二氧化碳分压（PaCO2）和动脉血氧分压（PaO2）比较，差异均有统计学意义（P＜0.05），且改善程度高剂量组患者＞中剂量组＞低剂量组，差异均有统计学意义（P＜0.05）。3组患者均未见严重不良反应发生。结论：2.0 mg布地奈德联合异丙托溴铵雾化吸入能有效改善AECOPD患者的肺功能、主观症状和动脉血气指标，且安全性较高。 |
| ABSTRACT： | OBJECTIVE： To investigate the safety and effects of different doses of budesonide combined with ipratropium bromide on rational symptom， lung function and arterial blood gas indexes of patients with acute exacerbation of chronic obstructive pulmonary diseases （AECOPD）. METHODS： 186 AECOPD inpatients were selected and randomly divided into low-dose， medium-dose and high-dose groups， with 61 cases in each group. All groups received routine treatment as ipratropium bromide 500 μg+0.9％ Sodium chloride injection （NS） 2 ml， oral inhalation with oxygen drive atomization nebulizer， oxygen flow rate of 4-5 L/min，15-20 min/time，tid. Low-dose， medium-dose and high-dose group were additionally given Budesonide suspension 0.5， 1.0， 2.0 mg+NS 2 ml respectively， oral inhalation with oxygen drive atomization nebulizer， oxygen flow rate of 4-5 L/min 20 min/time， bid. Patients in 3 groups were treated for 7 days. Pulmonary function， MRC score， arterial blood gas indexes and ADR were compared among 3 groups before treatment， 3 and 7 days after treatment. RESULTS： FEV1％ of 3 groups were significantly improved after treatment； 3 and 7 days after treatment， FEV1％ of high-dose group was higher than that of medium-dose and higher than that of low-dose group， with statistical significance （P＜0.05）. The MRC scales of 3 groups were significantly decreased after treatment； 3 days after treatment， MRC scale of high-dose group was lower than those of medium-dose and lower than that of low-dose group， with statistical significance （P＜0.05）. 7 days after treatment， MRC scales of medium-dose and low-dose groups were lower than that of low-dose group， with statistical significance （P＜0.05）， but there was no statistical significance in MRC scale between high-dose group and medium-dose group after treatment 7 days （P＞0.05）. After treatment， there was statistical significance in PaCO2 and PaO2 among 3 groups （P＜0.05）， and the improvement of high-dose group was better than those of medium-dose and better than that of low-dose group， with statistical significance （P＜0.05）. No severe ADR was found in 3 groups. CONCLUSIONS： Aerosol inhalation of 2.0 mg budesonide combined with ipratropium bromide can effectively improve pulmonary function， rational symptoms and arterial blood gas indexes with good safety. |
| 期刊： | 2016年第27卷第20期 |
| 作者： | 吴清松，饶平 |
| AUTHORS： | WU Qingsong，RAO Ping |
| 关键字： | 慢性阻塞性肺疾病；急性加重期；糖皮质激素；异丙托溴铵；剂量；布地奈德 |
| KEYWORDS： | Chronic obstructive pulmonary disease； Acute exacerbation； Glucocorticoid； Ipratropium bromide； Dose； Budesonide |
| 阅读数： | 313 次 |
| 本月下载数： | 2 次 |
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