论文部分内容阅读
COPD急性加重是激素治疗的适应证 讨论COPD治疗首先应区分急性加重期和缓解期。Thompson等的研究中,起始剂量60mg强的松口服9天,迅速减量,动脉氧分压,肺泡-动脉氧分压差和呼气峰流速的改善明显好于对照组,且治疗失败和呼吸困难也较少见。Niewoehner等的研究也证实了这一结果,试验组头72h内每6h静脉注射甲基强的松龙125mg,继以60mg强的松口服,并渐减量到第15天。结果,安慰剂组治疗失败率明显高于试验组,而试验组住院时间短于安慰剂组,FEV_1提高。根据上述两研究,COPD加重期仅需行短程激素治疗,且可明显降低不良反应,同时使用抗生素则效果更佳。
Acute exacerbations of COPD are indications for the treatment of steroids COPD treatment should first distinguish between acute exacerbation and remission. Thompson and other studies, the initial dose of prednisone 60mg oral 9 days, rapid reduction, arterial partial pressure of oxygen, alveolar - arterial partial pressure of oxygen and peak expiratory flow was significantly better than the control group, and the failure of treatment and Breathing difficulties are rare. Niewoehner and other studies also confirmed this result, intravenous injection of methylprednisolone 125mg every 6h within the first 72h, followed by 60mg prednisone orally, and gradually reduced to the first 15 days. As a result, the failure rate of placebo treatment was significantly higher than that of the test group, while the study group shorter hospital stay than the placebo group, FEV_1 increased. According to the above two studies, COPD exacerbation only need to be treated with short-hormones, and can significantly reduce the adverse reactions, while using antibiotics is better.