Application of Sufficient Doses of Nebulized Budesonide in the Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease with Severe Airflow Restriction_West China Medical Journal

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The Third People’ s Hospital of Chengdu City,Chengdu Sichuan 610031, China;

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Keywords：

慢性阻塞性肺疾病; 布地奈德; 甲潑尼龍; 霧化吸入

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目的:評價足量布地奈德溶液霧化治療重度慢性阻塞性肺疾病急性加重期患者的臨床應用價值。方法: 90例30%≤FEV1 lt;50%的重度COPD急性加重期患者隨機分為3組: 布地奈德組給予布地奈德溶液霧化吸入2mg/次,每8小時1次;甲潑尼龍組給予口服甲潑尼龍片24mg /次,1/日;對照組不使用任何糖皮質激素。療程10d,觀察3組患者治療后肺功能,動脈血氣和呼吸困難評分變化,以及糖皮質激素主要不良反應。結果: 與對照組相比,吸入布地奈德組和口服甲潑尼龍組在FEV1,PaO2,PaCO2和呼吸困難評分改善值方面,有顯著差異性(P lt;005);吸入布地奈德組和口服甲潑尼龍組兩組各項指標改善程度相似(P gt;005);吸入布地奈德組和對照組的不良反應少于口服甲潑尼龍組 (P lt;005)。〖HTH〗結論:〖HTSS〗足量布地奈德溶液霧化治療與口服糖皮質激素療效相近,全身副作用小,安全性好,是重度COPD急性加重期糖皮質激素的有效選擇。

Citation： YIN Jun,LI Qun,CHENG Feng,et al. Application of Sufficient Doses of Nebulized Budesonide in the Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease with Severe Airflow Restriction. West China Medical Journal, 2009, 24(5): 1131-1133. doi: Copy

1.	NHLBI/WHO workshop report: Gobal strategy for the Diagnosis, Management, and Prevention of Chronic obstructive Pulmonary Disease. 2006.
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3.	National Heart, Lung, and Blood Institute. Global initrative for chronic obstructive pulmonary disease. NHLBI Workshop Repot 2701,22001, Apr. Chapter 4.
4.	FABBN L M, DURHAM S, HOLGATE S T, et al. Niewoehneral. Assessment of airway inflammation: an overview[J]. Eur Respir J Suppl, 1998,26:6s8s..
5.	MALTAIS F, OSTINELLI J, BOURBEAU J, et al. Comparison of nebulized acute exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial[J]. Am J Respir Care Med,2002,165:698703.
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7.	NIEWOEHNER D E, ERBLAND M L, DEUPREE R H, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease[J]. N Engl J Med,1999,340:19411947.
8.	SONG I H, BUTTGEREIT F. Nongenomic glucocorticoid effects to provde the basis for new drug develooments[J]. Mol Cell Endocrinol,2006,246(12):1426.
9.	MENDES E S, PEREIRA A, DANTA I, et al. Comparative bronchial vasoconstrictive efficacy of inhaled glucocorticosteroids[J]. Eur Respir J, 2003,21 (6):98993.
10.	MIRICI A, MERAL M, AKGUN M. Comparison of the Efficacy of Nebulised Budesonide with Parenteral Corticosteroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease[J]. Clin Drug Invest, 2003,23 (1):5562.
11.	OUDIJK E J, LAMMERS J W, KOENDERMAN L. Systemic inflammation in chronic obstructive pulmonary disease[J]. Eur Respir J,2003,46:S5S13.

1. NHLBI/WHO workshop report: Gobal strategy for the Diagnosis, Management, and Prevention of Chronic obstructive Pulmonary Disease. 2006.
2. CELI B R, MACNEE W. Standards for the diagnosis and treatment of patients with COPD: asummayy of the ATS/ERS position paper[J]. Eur Respir J, 2004,23:932946.
3. National Heart, Lung, and Blood Institute. Global initrative for chronic obstructive pulmonary disease. NHLBI Workshop Repot 2701,22001, Apr. Chapter 4.
4. FABBN L M, DURHAM S, HOLGATE S T, et al. Niewoehneral. Assessment of airway inflammation: an overview[J]. Eur Respir J Suppl, 1998,26:6s8s..
5. MALTAIS F, OSTINELLI J, BOURBEAU J, et al. Comparison of nebulized acute exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial[J]. Am J Respir Care Med,2002,165:698703.
6. 韓偉,周新.布地奈德霧化治療在COPD急性加重期的應用[J].實用臨床醫藥雜志,2004,8:68.
7. NIEWOEHNER D E, ERBLAND M L, DEUPREE R H, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease[J]. N Engl J Med,1999,340:19411947.
8. SONG I H, BUTTGEREIT F. Nongenomic glucocorticoid effects to provde the basis for new drug develooments[J]. Mol Cell Endocrinol,2006,246(12):1426.
9. MENDES E S, PEREIRA A, DANTA I, et al. Comparative bronchial vasoconstrictive efficacy of inhaled glucocorticosteroids[J]. Eur Respir J, 2003,21 (6):98993.
10. MIRICI A, MERAL M, AKGUN M. Comparison of the Efficacy of Nebulised Budesonide with Parenteral Corticosteroids in the Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease[J]. Clin Drug Invest, 2003,23 (1):5562.
11. OUDIJK E J, LAMMERS J W, KOENDERMAN L. Systemic inflammation in chronic obstructive pulmonary disease[J]. Eur Respir J,2003,46:S5S13.

West China Medical Journal

Application of Sufficient Doses of Nebulized Budesonide in the Treatment of Exacerbations of Chronic Obstructive Pulmonary Disease with Severe Airflow Restriction

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