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目的探讨雾化吸入不同剂量糖皮质激素联合复方异丙托溴铵溶液治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效。方法选取上海市同仁医院2011年1月—2012年1月收治的84例AECOPD住院患者,按照随机数字表法将其分为大剂量组和小剂量组,每组42例。两组患者在常规治疗的基础上同时加用不同剂量的布地奈德联合复方异丙托溴铵溶液,比较治疗前后两组患者的临床症状评分、Pa O2、Pa CO2、第1秒用力呼气量(FEV1)以及FEV1占用力肺活量(FVC)百分比(FEV1/FVC),观察治疗中不良反应发生情况。结果治疗后大剂量组临床症状评分及Pa CO2均低于小剂量组,Pa O2高于小剂量组,差异有统计学意义(P<0.05)。治疗后大剂量组FEV1%、FEV1/FVC、FEV1高于小剂量组,差异有统计学意义(P<0.05)。结论大剂量糖皮质激素联合复方异丙托溴铵溶液联合雾化吸入能够显著改善AECOPD的临床症状以及肺功能,并且安全有效。
Objective To investigate the efficacy of inhalation of different doses of glucocorticoid combined with ipratropium bromide in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Eighty-four AECOPD inpatients admitted to Tongren Hospital of Shanghai from January 2011 to January 2012 were divided into high dose group and low dose group according to the random number table method, with 42 patients in each group. Two groups of patients on the basis of conventional treatment while adding different doses of budesonide combined with ipratropium bromide solution before and after treatment in both groups were compared clinical symptom score, Pa O2, Pa CO2, 1 second forced expiratory (FEV1) and FEV1 occupancy FVC (FEV1 / FVC) were measured to observe the adverse reactions during treatment. Results After treatment, the scores of clinical symptoms and the PaCO 2 in the high-dose group were lower than those in the low-dose group and Pa O 2 was higher than the low-dose group. The difference was statistically significant (P0.05). After treatment, FEV1%, FEV1 / FVC and FEV1 in high-dose group were higher than those in low-dose group, the difference was statistically significant (P <0.05). Conclusion High-dose glucocorticoid combined with ipratropium bromide solution and inhalation can significantly improve the clinical symptoms and lung function of AECOPD, and is safe and effective.