两种糖皮质激素给药方案治疗老年AECOPD患者的临床观察
发布时间：2018-07-23 08:27
【摘要】：目的:探讨糖皮质激素5 d和15 d给药方案对老年慢性阻塞性肺疾病急性加重期(AECOPD)患者临床疗效、肺功能和生活质量的影响及用药安全性。方法:选取海口市第四人民医院2013年5月-2015年12月收治的老年AECOPD患者160例,按抽签法分为A组和B组,各80例。入选患者均给予祛痰平喘、控制感染等对症治疗。在此基础上,A组患者给予注射用甲泼尼龙琥珀酸钠40 mg/d,连用15 d,B组患者给予注射用甲泼尼龙琥珀酸钠40 mg/d,连用5 d。比较两组患者的临床疗效,治疗前后的肺通气功能指标水平、血气分析指标水平和Spitzer生活质量指数量表(QLI)评分,以及不良反应发生情况。结果:A组患者的总有效率为92.50%,B组为90.00%,两组比较差异无统计学意义(P0.05)。治疗前,两组患者的肺通气功能指标水平、血气分析指标水平和QLI评分比较,差异均无统计学意义(P0.05)。治疗后,两组患者的用力肺活量、第1秒用力呼气量(FEV1)、FEV1占预计值百分比和氧分压均明显高于治疗前,二氧化碳分压均明显低于治疗前,差异均有统计学意义(P0.05),但组间比较差异无统计学意义(P0.05)。两组患者的QLI评分均明显高于治疗前,且B组明显高于A组,差异有统计学意义(P0.05)。B组患者的不良反应发生率(6.25%)明显低于A组(22.50%),差异有统计学意义(P0.05)。结论:糖皮质激素5 d和15 d给药方案在改善老年AECOPD患者肺功能方面的疗效接近,但5 d给药方案更能有效提高患者的生活质量、降低不良反应发生风险,更具临床应用价值。
[Abstract]:Objective: to investigate the effects of glucocorticoid on the clinical efficacy, pulmonary function, quality of life and safety of medication in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) after 5 and 15 days of administration of glucocorticoid. Methods: 160 elderly AECOPD patients admitted to Haikou fourth people's Hospital from May 2013 to December 2015 were divided into group A and group B by drawing lots. Selected patients were given expectorant asthma, control infection and other symptomatic treatment. On this basis, patients in group A were given 40 mg / d methylprednisolone sodium succinate for injection, and patients in group B were given 40 mg / d of sodium methylprednisolone succinate for 5 days. The clinical efficacy, pulmonary ventilation function index, blood gas analysis index and Spitzer quality of life index (QLI) score before and after treatment were compared between the two groups, as well as the occurrence of adverse reactions. Results the total effective rate of group A was 92.50 and that of group B was 90.00.The difference between the two groups was not statistically significant (P0.05). Before treatment, there was no significant difference in pulmonary ventilation function, blood gas analysis and QLI score between the two groups (P0.05). After treatment, the forced vital capacity, FEV1 / FEV1 percentage and oxygen partial pressure in both groups were significantly higher than those before treatment, and the partial pressure of carbon dioxide was significantly lower than that before treatment. The differences were statistically significant (P0.05), but there was no significant difference between the groups (P0.05). The QLI scores of the two groups were significantly higher than those of the patients before treatment, and group B was significantly higher than group A, the difference was statistically significant (P0.05). The incidence of adverse reactions in group B (6.25%) was significantly lower than that in group A (22.50%), and the difference was statistically significant (P0.05). Conclusion: the effects of glucocorticoid administration on lung function in aged patients with AECOPD for 5 and 15 days are similar, but 5-day regimen is more effective to improve the quality of life, reduce the risk of adverse reactions, and have more clinical application value.
【作者单位】： 海口市第四人民医院急诊科;海南医学院附属医院急诊ICU;
【分类号】：R563.9
本文编号：2138797
[Abstract]:Objective: to investigate the effects of glucocorticoid on the clinical efficacy, pulmonary function, quality of life and safety of medication in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) after 5 and 15 days of administration of glucocorticoid. Methods: 160 elderly AECOPD patients admitted to Haikou fourth people's Hospital from May 2013 to December 2015 were divided into group A and group B by drawing lots. Selected patients were given expectorant asthma, control infection and other symptomatic treatment. On this basis, patients in group A were given 40 mg / d methylprednisolone sodium succinate for injection, and patients in group B were given 40 mg / d of sodium methylprednisolone succinate for 5 days. The clinical efficacy, pulmonary ventilation function index, blood gas analysis index and Spitzer quality of life index (QLI) score before and after treatment were compared between the two groups, as well as the occurrence of adverse reactions. Results the total effective rate of group A was 92.50 and that of group B was 90.00.The difference between the two groups was not statistically significant (P0.05). Before treatment, there was no significant difference in pulmonary ventilation function, blood gas analysis and QLI score between the two groups (P0.05). After treatment, the forced vital capacity, FEV1 / FEV1 percentage and oxygen partial pressure in both groups were significantly higher than those before treatment, and the partial pressure of carbon dioxide was significantly lower than that before treatment. The differences were statistically significant (P0.05), but there was no significant difference between the groups (P0.05). The QLI scores of the two groups were significantly higher than those of the patients before treatment, and group B was significantly higher than group A, the difference was statistically significant (P0.05). The incidence of adverse reactions in group B (6.25%) was significantly lower than that in group A (22.50%), and the difference was statistically significant (P0.05). Conclusion: the effects of glucocorticoid administration on lung function in aged patients with AECOPD for 5 and 15 days are similar, but 5-day regimen is more effective to improve the quality of life, reduce the risk of adverse reactions, and have more clinical application value.
【作者单位】： 海口市第四人民医院急诊科;海南医学院附属医院急诊ICU;
【分类号】：R563.9
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