摘要
目的观察糖皮质激素联合特布他林治疗晚期慢性阻塞性肺疾病(COPD)的疗效。方法选取2012年1月-2014年1月在重庆市丰都县某医院收治的晚期COPD患者92例,随机分为联合组和对照组,每组46例。在给予常规对症治疗的基础上,对照组采用特布他林气雾剂5mg吸入,联合组在对照组的基础上吸入丙酸氟替卡松气雾剂100μg。观察临床治疗效果、痰标本炎症细胞计数、肺通气功能与动脉血气等相关指标的变化。结果联合组患者显效率和总有效率高于对照组(P<0.05)。与治疗前相比,联合组和对照组患者治疗后痰标本中中性粒细胞、嗜酸性粒细胞明显减少,巨噬细胞明显增多(P<0.05);与对照组治疗后相比,联合组患者治疗后痰标本中中性粒细胞、嗜酸性粒细胞减少,巨噬细胞增多(P<0.05)。与治疗前相比,联合组和对照组患者治疗后第一秒用力呼气容积(FEV1)、肺活量(VC)、用力肺活量(FVC)、最大呼气流量(PEF)增大,动脉血二氧化碳分压(PaCO2)变小,联合组最大通气量(MVV)、动脉血氧分压(PaO2)增大(P<0.05);与对照组治疗后相比,联合组患者治疗后FEV1,VC,FVC,PEF,PaO2增大,PaCO2变小(P<0.05)。结论糖皮质激素联合特布他林治疗晚期COPD效果显著,明显改善了患者的肺功能和生活质量,值得在临床上进行推广。
Objective To investigate the efficacy of glucocorticoid combined with terbutaline on the treatment of advanced chronic obstructive pulmonary disease （COPD）. Method 92 cases of patients with advanced COPD received in a hospital of Fengdu County from January 2012 to January 2014 were randomly divided into a combination group and a control group, 46 cases in each group. Under the conventional symptomatic treatment, the control group was given the inhalation of terbutaline aerosol 5 mg. The combination group was given the inhalation of fluticasone propionate 100 μg on the basis of the control group. Then the clinical efficacy and changes in count of sputum inflammatory cells, pulmonary ventilation function, arterial blood gas and other related indicators were observed. Results The marked effective rate and total efficiency in the combination group were higher than the control group （P〈0.05）. After the treatment, neutrophils and eosinophils in the sputum specimens decreased significantly and macrophages increased significantly （P〈0.05） in both groups. Compared with the control group, neutrophils and eosinophiIs in the sputum specimens decreased and macrophages increased （P〈0.05） in the combination group after the treatment. The forced expiratory volume in one second （FEV1）, vital capacity （VC）, forced vital capacity （FVC） and peak expiratory flow （PEF） increased and partial pressure of carbon dioxide in artery （PaCO2） decreased after the treatment in the two groups and in the combination group, the maximum voluntary ventilation （MVV） and partial pressure of oxygen （PaO2） increased （P〈0.05） ; compared to the control group, FEV1 , VC, FVC, PEF and PaO2 increased, PaCO2 decreased （P〈0.05） in the combination group. Conclusion Glucocorticoid combined with terbutaline on the advanced COPD has a positive effect, can significantly improve lung function and quality of life in patients and deserves clinical promotion.
出处
《保健医学研究与实践》
2015年第1期58-61,共4页
Health Medicine Research and Practice
关键词
糖皮质激素
特布他林
晚期
慢性阻塞性肺疾病
疗效
Glucocorticoids
Terbutaline
Advanced
Chronic obstructive pulmonary disease
Efficacy
