摘要
目的探讨硫酸沙丁胺醇联合不同剂量布地奈德混悬液雾化吸入治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床效果。方法我院180例AECOPD患者,按随机数字表法分为高剂量组、中剂量组及低剂量组各60例,均给予硫酸沙丁胺醇联合布地奈德混悬液雾化吸入治疗,布地奈德给药剂量:高剂量组4.0 mg/d,中剂量组2.0 mg/d,低剂量组1.0mg/d,比较三组临床疗效、肺功能与血气指标水平、痰液炎性因子水平、血糖与骨代谢指标水平及不良反应发生情况。结果高剂量组与中剂量组临床治疗有效率比较,差异无统计学意义(P>0.05),但两组临床治疗有效率均高于低剂量组(P<0.05);高剂量组治疗后用力呼气末容积(FEV1)、一秒率(FEV1/FVC)、动脉氧分压(PbO2)水平高于中剂量组和低剂量组,动脉二氧化碳分压(PaCO2)、痰液中白细胞介素(IL)-6、IL-8及肿瘤坏死因子-α(TNF-α)水平低于中剂量组和低剂量组(P<0.05);三组治疗前后血糖、骨代谢水平及不良反应发生率比较,差异无统计学意义(P>0.05)。结论硫酸沙丁胺醇联合高剂量布地奈德混悬液雾化吸入治疗AECOPD的临床效果显著,可有效改善患者肺功能与血气指标,降低痰液中炎性因子水平,安全性较高。
Objective To investigate clinical effect of salbutamol sulfate combined with different doses of budesonide suspension for aerosol inhalation in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 180 AECOPD patients in our hospital were enrolled.They were randomly divided into high-dose group,middle-dose group and lowdose group,60 in each group.The three groups were treated with salbutamol sulfate combined with budesonide suspension for aerosol inhalation.Administration dosages of budesonide in the high-dose group,middle-dose group and low-dose group were 4.0 mg/d,2.0 mg/d and 1.0 mg/d,respectively.The clinical curative effect,pulmonary function,levels of blood gas indexes,sputum inflammatory factors,blood glucose and bone metabolism indexes,and occurrence of adverse reactions were compared among the three groups.Results There was no significant difference in response rate of clinical treatment between the high-dose group and the middle-dose group(P>0.05).The response rate of clinical treatment in the high-dose group and the middle-dose group was higher than that in the low-dose group(P<0.05).After treatment,levels of forced expiratory volume in 1 s(FEV1),FEV1/forced vital capacity(FEV1/FVC)and arterial oxygen partial pressure(PbO2)were the highest in the high-dose group followed by the middle-dose group and the low-dose group(P<0.05).After treatment,the arterial carbon dioxide partial pressure(PbCO2)in the high-dose group was lower than that in the middledose group and the low-dose group(P<0.05).After treatment,inflammatory factors in sputum such as interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)was lower in the high-dose group than those in the middle-dose group and the lowdose group(P<0.05).There was no significant difference in blood glucose or bone metabolism level before and after treatment among the three groups(P>0.05).There was no significant difference in incidence of adverse reactions among the three groups(P>0.05).Conclusion The clinical curative effect of salbutamol sulfate combined with high-dose budesonide suspension for aerosol inhalation in the treatment of AECOPD is significant.The therapy can effectively improve the pulmonary function and blood gas indexes of patients and reduce the levels of inflammatory factors in sputum.It also has higher safety.
作者
陈亮
龚勇
吴旭
CHEN Liang;GONG Yong;WU Xu(Department of Respiratory and Critical Care,Jiajiang County People's Hospital,Leshan 614100,China)
出处
《实用医院临床杂志》
2020年第3期151-154,共4页
Practical Journal of Clinical Medicine
关键词
布地奈德
硫酸沙丁胺醇
慢性阻塞性肺疾病
急性加重期
肺部感染
Budesonide
Salbutamol sulfate
Chronic obstructive pulmonary disease
Acute exacerbation
Pulmonary infection
