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目的：评价甲强龙与普米克令舒序贯治疗老年 AECOPD 的疗效。方法将56例临床确诊的中、重度老年 AECOPD 患者随机分为序贯治疗组(26例)和甲强龙组(30例)。序贯治疗组给予甲强龙40 mg qd 静脉滴注,3天后调整为普米克令舒2 mg q8h 雾化吸入,甲强龙组持续给予甲强龙40 mg qd 静脉滴注,两组激素疗程均为10天,分别观察两组治疗后3、10天呼吸困难等级(mMRC)、FEV1% pred、PaO2和 PaCO2改善情况。结果治疗后10天 mMRC、FEV1% pred、PaO2和 PaCO2与治疗前相比明显改善,差异均具有统计学意义(P <0．05)。序贯治疗组不良反应明显少于甲强龙组。结论甲强龙和普米克令舒序贯治疗老年中、重度 AECOPD 可获得与全身使用甲强龙一致的效果,不良反应较后者明显减少。“,”Objective To evaluation the effect of methylprednisolone and Pulmicort in the sequential treat-ment of elderly AECOPD patients. Methods 56 elderly patients with moderate and severe COPD were randomly di-vided into the sequential group (n = 26) and the methylprednisolone group (n = 30). The sequential group received intravenous methylprednisolone (40mg qd), and then was given Pulmicort inhalation (2mg q6h) after three days. The methylprednisolone group continued to give methylprednisolone intravenously (40mg qd). The treatment lasted ten days. Dyspnea rating (mMRC), FEV1% predicted, PaO2 and PaCO2 were observed and compared between the two groups. Results The mMRC, FEV1% pred, PaO2 and PaCO2 improved significantly 10 days after the treatment (P < 0. 05). The incidence of adverse reactions was lower in the sequential treatment group than in the methylpred-nisolone group. Conclusion Methylprednisolone and Pulmicort sequential treatment has the similar curative effect with methylprednisolone dose in the treatment of AECOPD, but the former has less adverse reaction.