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目的探讨布地奈德联合甲强龙治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及安全性。方法将2011年9月~2015年5月入住的77例老年AECOPD患者按照治疗方法分为对照组(n=38)与观察组(n=39)。两组患者均首先接受基础治疗,对照组在此基础上给予40 mg甲强龙,静滴;观察组在对照组基础上联合布地奈德2.0 mg,tid,吸入治疗。比较两组临床疗效、肺功能及安全性。结果经治疗,观察组临床总有效率为89.74%(35/39),对照组为68.42%(26/38),二组疗效差异具有统计学意义(P<0.05);两组患者治疗后临床症状评分、呼吸困难分级、Pa CO2及肺泡灌洗液中性粒细胞计数水平均显著低于治疗前(P<0.05),两组患者治疗后FEV1及Pa O2水平均显著高于治疗前(P<0.05),且两组治疗后上述指标水平差异均具有统计学意义(P<0.05);两组患者在治疗前后的生命体征均在正常范围内;血常规、生化指标复查结果正常;所有患者均未见其它不可预见性的药物毒副反应。结论布地奈德联合甲强龙序贯治疗老年AECOPD的疗效显著,安全性高。
Objective To investigate the efficacy and safety of budesonide combined with methylprednisolone in the treatment of acute exacerbation of aged chronic obstructive pulmonary disease (AECOPD). Methods Seventy-five elderly AECOPD patients admitted from September 2011 to May 2015 were divided into control group (n = 38) and observation group (n = 39) according to the treatment method. The patients in both groups received the first basic treatment. The control group was given 40 mg methylprednisolone on the basis of the above treatment. The observation group was treated with budesonide 2.0 mg, tid, and inhalation on the basis of the control group. The clinical efficacy, lung function and safety of the two groups were compared. Results After treatment, the total clinical effective rate was 89.74% (35/39) in the observation group and 68.42% (26/38) in the control group, with significant difference between the two groups (P <0.05) Symptom score, dyspnea classification, PaCO 2 and alveolar lavage fluid neutrophil count were significantly lower than those before treatment (P <0.05). The levels of FEV 1 and Pa 2 O in both groups were significantly higher than those before treatment (P <0.05). The differences of the above indexes between the two groups were statistically significant (P <0.05). The vital signs of both groups were within the normal range before and after treatment. The blood and biochemical indexes were normal. All the patients No other unpredictable drug toxicity. Conclusion Budesonide combined with methylprednisolone sequential treatment of elderly AECOPD significant effect, high safety.