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目的 观察和比较氧驱动高剂量异丙托品雾化吸入对慢性阻塞性肺疾病 (COPD)急性恶化的疗效和安全性。方法 3 2例住院COPD急性恶化患者随机均分为对照组 (异丙托品常规剂量吸入 ,每次吸入剂量 40μg ,每日 3次 )和治疗组 (高剂量异丙托品雾化吸入 ,每次吸入剂量 5 0 0 μg ,每日 3次 )。记录治疗前和治疗后0 .2 5、0 .5、1、2、4、6h和 1周时的肺功能、动脉血压、症状和用药反应 ,统计两组恶化持续天数。结果 两组在治疗后 0 .2 5、0 .5、1、2、4、6h一秒钟用力呼气量 (FEV1 )均显著升高 (P <0 .0 5 ) ,治疗组治疗后 0 .2 5hFEV1 为1.2 7L ,0 .5h为 1.40L ,1h为 1.3 8L ,2h为 1.3 0L ,6h为 0 .2 5L ,对照组相应为 1.17、1.2 2、1.2 8、1.2 3、1.16和 1.14L。用药后治疗组 0 .2 5、0 .5、1、2、4及 6h的FEV1 值增高均大于对照组 (P <0 .0 5 )。此外 ,两组用药 1周后 ,肺功能和动脉血气均明显改善 ,但治疗组较对照组更明显 (P <0 .0 5 )。治疗组平均恶化持续天数和住院天数均较短 ,分别为 10 .5d和 11.4d ;对照组较长 ,分别为 15 .7d和 16.4d ,两组用药后的不良反应均少而轻微 ,且差异无显著性。结论 氧驱动高剂量异丙托品雾化吸入治疗COPD急性恶化较常规剂量吸入异丙托品效果更显著 ,其扩张气道明显 ,
Objective To observe and compare the efficacy and safety of aerosol-driven high-dose ipratropium aerosol inhalation for acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 32 hospitalized patients with acute exacerbation of COPD were randomly divided into control group (normal dose of ipratropium inhalation, 40μg per inhalation dose, 3 times daily) and treatment group (high dose ipratropium inhalation, Inhalation dose 500 μg, 3 times a day). The pulmonary function, arterial blood pressure, symptoms and medication responses at 0.2, 0.5, 0.5, 1, 2, 4, 6h and 1weeks before and after treatment were recorded. Results After the treatment, the forced expiratory volume (FEV1) of one group at 0.5, 0.5, 1, 2, 4 and 6 h after treatment were significantly increased (P <0.05) .2 5hFEV1 was 1.2 7L, 0.5h was 1.40L, 1h was 1.3 8L, 2h was 1.3 0L, 6h was 0.52L, and the control group was 1.17,1.2 2,1.2 8,1.2 3,1.16 and 1.14L . After treatment, the increase of FEV1 in treatment groups at 0.5, 0.5, 1, 2, 4, and 6 hours was higher than that in control group (P <0.05). In addition, after 1 week of treatment, both pulmonary function and arterial blood gas significantly improved, but the treatment group was more obvious than the control group (P <0.05). The average duration of treatment and days of hospitalization were shorter in the treatment group (10.5d and 11.4d, respectively), while those in the control group were longer (15.7 and 16.4 days, respectively). Adverse reactions were insignificant and slight in both groups No significant. Conclusion Oxygen-driven high-dose ipratropium aerosol inhalation treatment of acute exacerbation of COPD than conventional dose of ipratropium effect is more pronounced, the expansion of the airway significantly,