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目的观察静脉使用甲泼尼龙与雾化布地奈德治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效、安全性。方法 68例AECOPD患者随机分为甲泼尼龙组及布地奈德组,各34例。治疗10 d后观察第一秒用力呼气容积(FEV1)、二氧化碳分压(PCO2)、氧分压(PO2)、CAT评分和不良反应。结果两组患者FEV1、PCO2、PO2、CAT评分较治疗前均显著改善(P<0.05),但两组间差异均无统计学意义(P>0.05);布地奈德组不良反应发生率显著低于甲泼尼龙组(P<0.05)。结论雾化吸入布地奈德与静脉滴注甲泼尼龙均能改善气流受限,缓解临床症状,两者疗效相似,但布地奈德组全身副作用较小,可作为AECOPD患者激素治疗的理想选择。
Objective To observe the efficacy and safety of intravenous administration of methylprednisolone and budesonide in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods AECOPD 68 patients were randomly divided into methylprednisolone group and budesonide group, 34 cases each. The first second forced expiratory volume (FEV1), partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), CAT score and adverse reactions were observed after 10 days of treatment. Results The FEV1, PCO2, PO2 and CAT scores in both groups were significantly improved compared with before treatment (P <0.05), but there was no significant difference between the two groups (P> 0.05). The incidence of adverse reactions in the budesonide group was significantly lower In methylprednisolone group (P <0.05). Conclusion Inhaled budesonide and intravenous methylprednisolone can both improve airflow limitation and relieve clinical symptoms. The efficacy of budesonide is similar to that of budesonide, but systemic side effects of budesonide group are small, so it can be used as hormone therapy in patients with AECOPD.