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目的 探讨大剂量皮质激素吸入是否有助于 β激动剂对高原地区重症哮喘发作的治疗。方法 采用随机双盲对照方法 ,将 42例高原地区重症哮喘发作患者分为布地奈德组和对照组 ,每组 2 1例。两组先吸入特布他林气雾剂 2 5mg,然后布地奈德组吸入布地奈德气雾剂 1 2mg ,对照组吸入安慰剂。 10min后各重复 1次。所有受试者给药前、后检查肺功能、辅助呼吸肌活动 ,并观察患者呼吸困难、哮鸣音变化。后 3项依据严重程度计分 ,平均值为临床指数。结果 给药后 1、2、4、6h布地奈德组一秒钟用力呼气容积占预计值百分比 (FEV1占预计值 % )分别为 (4 3± 5 ) %、(5 0± 5 ) %、(5 7± 5 ) %、(6 7± 6 ) % ;最大呼气流量占预计值百分比 (PEF占预计值 % )分别为 (4 7± 5 ) %、(5 5±6 ) %、(6 2± 7) %、(6 9± 7) % ;临床指数分别为 5 1± 0 8、4 3± 0 6、3 5± 0 6、2 5± 0 4和对照组 [FEV1占预计值 % :分别为 (4 2± 5 ) %、(4 4± 5 ) %、(4 5± 5 ) %、(4 5± 5 ) % ;PEF占预计值 % :分别为 (4 6± 5 ) %、(4 7± 5 ) %、(4 9± 6 ) %、(4 9± 6 ) % ;临床指数分别为 5 3± 0 7、5 0± 0 5、4 9± 0 7、4 8± 0 7]与给药前[布地奈德组 :分别为 (35± 5 ) %、(38± 5 ) %、8 3± 1 0 ;对照组 :分
Objective To investigate whether high-dose inhaled corticosteroids can help β-agonists in the treatment of severe asthma attacks in the plateau. Methods A total of 42 patients with severe asthma attack in the plateau were divided into two groups according to a randomized, double-blind comparative study: budesonide group and control group. The two groups inhaled terbutaline aerosol 25mg, then budesonide group inhaled budesonide aerosol 12mg, the control group inhaled placebo. After 10min each repeat 1 times. All subjects before and after administration of pulmonary function tests to assist respiratory activity, and observation of patients with dyspnea, wheezing changes. The last three items were scored according to the severity, and the average value was the clinical index. Results The percentage of forced expiratory volume per second in the budesonide group at 1, 2, 4 and 6 h postoperatively (FEV1% predicted) were (4 3 ± 5)% and (50 ± 5)% respectively , (57 ± 5)%, (67 ± 6)%, respectively; the maximum expiratory flow rate as a percentage of predicted value (PEF accounted for the predicted value%) were (47 ± 5) (6 2 ± 7)% and (69 9 ± 7)%, respectively; the clinical indexes were 51 ± 0 8,4 3 ± 0 6,3 5 ± 0 6,2 5 ± 0 4 and the control group (4 4 ± 5)%, (4 5 ± 5)% and (4 5 ± 5)%, respectively; PEF accounted for the predicted value%: (4 6 ± 5)%, ), (47 ± 5)%, (49 ± 6)% and (49 ± 6)%, respectively. The clinical indexes were 53 ± 0, 5 ± 0, 5, 49 ± 0, 8 ± 0 7] and pre-administration [budesonide group: (35 ± 5)%, (38 ± 5)%, 83 ± 10 respectively; control group: