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目的评价甲泼尼龙局部序贯治疗哮喘重度急性发作的疗效。方法入选急性重度哮喘52例,随机分成A组28例与B组24例,两组均给于甲泼尼龙80 mg,静脉滴注2次/d,用3 d,A组序贯口服甲泼尼龙片16 mg,1次/d,用5 d,B组序贯口服甲泼尼龙片8 mg用2 d同时吸入沙美特罗/丙酸氟替卡松50μg/250μg,2次/d,用5 d。结果静脉治疗第3天后,两组各项指标组内比较均明显改善,序贯治疗后则进一步改善。至第8天,A组的PEF值分别由治疗前的(186±92)L/min,上升至(321±102)L/min(P<0.05),FEV1由(1.32±0.43)L,上升至(1.87±0.52)L(P<0.05)。B组的PEF值由(192±88)L/min,上升至(335±115)L/min,FEV1由(1.41±0.39)L,上升至(1.93±0.72)L(P<0.05)。两组组间比较无显著差异(P>0.05)。A、B两组痰嗜酸细胞计数分别由(0.45%±1.3);(0.51%±1.9)减少至治疗后(0.07%±2.8);(0.04%±0.1),两组间比较无显著差异(P>0.05)。结论对哮喘重度急性发作应用口服或吸入激素疗效相似且安全可行。
Objective To evaluate the efficacy of methylprednisolone in the treatment of severe acute asthma attacks. Methods A total of 52 acute severe asthma patients were randomly divided into group A (n = 28) and group B (n = 24). Both groups were given methylprednisolone 80 mg twice a day for 3 days. Group A received oral methylprednisolone Nylon tablets 16 mg once daily for 5 days. Group B received sequential oral methylprednisolone tablets 8 mg. Salmeterol / fluticasone propionate 50 μg / 250 μg was inhaled simultaneously for 2 days for 5 days. Results After the third day of intravenous therapy, the indexes in both groups were significantly improved compared with those in the two groups, and were further improved after sequential therapy. By the 8th day, the PEF of group A increased from (186 ± 92) L / min before treatment to (321 ± 102) L / min before treatment and FEV1 increased from (1.32 ± 0.43) To (1.87 ± 0.52) L (P <0.05). PEF in group B increased from (192 ± 88) L / min to (335 ± 115) L / min, and FEV1 increased from (1.41 ± 0.39) L to (1.93 ± 0.72) L in group B (P <0.05). There was no significant difference between the two groups (P> 0.05). The sputum eosinophil counts in groups A and B decreased from (0.45% ± 1.3) and (0.51% ± 1.9) to 0.07% ± 2.8 and (0.04% ± 0.1) after treatment, respectively, with no significant difference between the two groups (P> 0.05). Conclusions Oral or inhaled hormones are effective and safe for severe acute asthma attacks.