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; 甲泼尼龙; 雾化吸入

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目的:评价足量布地奈德溶液雾化治疗重度慢性阻塞性肺疾病急性加重期患者的临床应用价值。方法: 90例30%≤FEV1 lt;50%的重度COPD急性加重期患者随机分为3组: 布地奈德组给予布地奈德溶液雾化吸入2mg/次,每8小时1次;甲泼尼龙组给予口服甲泼尼龙片24mg /次,1/日;对照组不使用任何糖皮质激素。疗程10d,观察3组患者治疗后肺功能,动脉血气和呼吸困难评分变化,以及糖皮质激素主要不良反应。结果: 与对照组相比,吸入布地奈德组和口服甲泼尼龙组在FEV1,PaO2,PaCO2和呼吸困难评分改善值方面,有显著差异性(P lt;005);吸入布地奈德组和口服甲泼尼龙组两组各项指标改善程度相似(P gt;005);吸入布地奈德组和对照组的不良反应少于口服甲泼尼龙组 (P lt;005)。〖HTH〗结论:〖HTSS〗足量布地奈德溶液雾化治疗与口服糖皮质激素疗效相近,全身副作用小,安全性好,是重度COPD急性加重期糖皮质激素的有效选择。

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.
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.	韩伟,周新.布地奈德雾化治疗在COPD急性加重期的应用[J].实用临床医药杂志,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.

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. 韩伟,周新.布地奈德雾化治疗在COPD急性加重期的应用[J].实用临床医药杂志,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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