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目的:观察雾化吸入大剂量(6mg/d)普米克令舒(布地奈德混悬液)治疗重度慢性阻塞性肺疾病急性发作(AECOPD)的临床疗效。方法:60例重度AECOPD住院患者随机分为两组:治疗组30例给予普米克令舒2 mg q8 h氧气驱动雾化吸入15 min;阳性对照组,30例给予地塞米松10m/d静脉滴注,两组患者均给予可必特(沙丁胺醇+异丙托溴胺)混悬液联合雾化吸入2 mL q8 h以及静脉滴注抗生素与吸氧、化痰或呼吸兴奋剂等治疗,记录两组患者用药前后临床症状体征以及PaO_2、PaCO_2、FEV_1的变化,同时观察不良反应及疗效分析。结果:两组患者治疗前后临床表现与PaO_2、PaCO_2、FEV_1均有改善,治疗前后相比差异有统计学意义(P<0.05);两组间总有效率相比(治疗组90%、对照组93.3%)差异无统计学意义(P>0.05);但治疗组不良反应明显少于对照组。结论:雾化吸入普米克令舒能够改善重度AECOPD患者肺功能及临床症状,与全身使用地塞米松疗效相近,但不良反应,安全性较好。
Objective: To observe the clinical effect of inhalation of high dose (6mg / d) pulmicral Shu (budesonide suspension) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Sixty hospitalized patients with severe AECOPD were randomly divided into two groups: 30 cases in the treatment group were treated with pulmicort respules 2 mg q8 h oxygen inhalation for 15 minutes; positive control group, 30 cases were given dexamethasone 10m / d intravenous drip Note, two groups of patients were given bebital (salbutamol + ipratropium bromide) suspension combined with atomization inhalation 2 mL q8 h and intravenous antibiotics and oxygen, phlegm or respiratory stimulants and other treatment, record two Before and after treatment, the clinical symptoms and signs, PaO_2, PaCO_2 and FEV_1 were observed before and after treatment. Adverse reactions and curative effects were also observed. Results: Before and after treatment, the clinical manifestations of both groups were improved with PaO_2, PaCO_2 and FEV_1, and the difference was statistically significant before and after treatment (P <0.05). The total effective rate of the two groups was 90% 93.3%) was no significant difference (P> 0.05); but the treatment group was significantly less adverse reactions than the control group. Conclusion: Pulmicort respules inhalation can improve lung function and clinical symptoms in patients with severe AECOPD. The efficacy of dexamethasone is similar to that of systemic dexamethasone, but adverse reactions and safety are good.