糖皮质激素两种给药方法治疗急性加重期慢性阻塞性肺疾病62例

发布时间：2019-06-15 08:28

【摘要】：目的评估全身性糖皮质激素不同的给药方法用于治疗急性加重期慢性阻塞性肺疾病的疗效。方法将急性加重期慢性阻塞性肺疾病患者62例,随机分为口服给药30例(口服组)和静脉滴注给药32例(静脉组)。口服组:第1~7天每天口服甲泼尼龙片32 mg;静脉组:第1~3天静脉滴注甲泼尼龙1 mg·kg-1·d-1,qd,第4~7天静脉滴注甲泼尼龙0.5 mg·kg-1·d-1,qd。其他治疗包括吸氧、抗感染、支气管扩张药及化痰药等使用。两组均以7 d为1个疗程,治疗1个疗程后,对两组治疗前后一秒钟用力呼气量(FEV1)、氧分压(PaO2)、生活质量评分(CAT)评分、呼吸困难量表(MMRC)及住院天数、是否并发高血压及高血糖进行观察检测,并在出院3个月内进行随访了解再发就诊情况。结果治疗后两组患者FEV1/pred%、PaO2、CAT评分、MMRC较治疗前均有改善(P0.05),且治疗后上述指标及住院天数在两组间差异无统计学意义(P0.05),但静脉组高血糖、高血压发生率明显高于口服组,静脉组患者出院后3个月内因复发加重再次就诊率明显高于口服组,差异有统计学意义(P0.05)。结论口服和静脉滴注糖皮质激素在治疗急性加重期慢性阻塞性肺疾病患者具有相同的疗效,且糖皮质激素口服给药因并发症较少而优于其静脉滴注给药。
[Abstract]:Objective to evaluate the efficacy of different methods of systemic glucocorticoid administration in the treatment of acute severe chronic obstructive pulmonary disease (COPD). Methods Sixty-two patients with acute exacerbation of chronic obstructive pulmonary disease were randomly divided into oral administration group (n = 30) and intravenous drip group (n = 32). Oral group: daily oral methylprednisolone tablets 32 mg; intravenous group: 1 ~ 3 days intravenous infusion of methylprednisolone 1 mg kg- 1 路d ~ (- 1), day 4 ~ 7 days intravenous infusion of methylprednisolone 0.5 mg kg- 1 路d ~ (- 1), Q ~ (- 1), d ~ (- 1), d ~ (- 1). Other treatments include oxygen inhalation, anti-infection, bronchodilators and expectorant use. Both groups were treated with 7 days as a course of treatment. After one course of treatment, forced respiratory volume (FEV1), partial pressure of oxygen (PaO2), quality of life score (CAT), respiratory distress scale (MMRC), hospitalization days, hypertension and hyperglycemia were observed and measured before and after treatment. The patients were followed up within 3 months to find out the recurrence of the treatment. Results after treatment, the FEV1/pred%,PaO2,CAT score and MMRC of the two groups were improved compared with those before treatment (P 0.05), and there was no significant difference in the above indexes and hospitalization days between the two groups (P 0.05). However, the incidence of hyperglycemia and hypertension in the vein group was significantly higher than that in the oral group within 3 months after discharge (P 0.05). Conclusion Oral and intravenous infusion of glucocorticoids has the same curative effect in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease, and oral administration of glucocorticoids is superior to intravenous infusion because of fewer complications.
【作者单位】：湖北医药学院附属人民医院呼吸内科;武汉市中心医院呼吸内科;
【分类号】：R563.9

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