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目的探讨异丙托溴铵、沙丁胺醇雾化吸入联合甲泼尼龙治疗急性加重期慢性阻塞性肺疾病(COPD)的临床疗效。方法选取2013年2月—2014年2月北京市海淀医院收治的98例急性加重期COPD患者,随机分为对照组和观察组各49例。对照组患者在常规治疗的基础上静脉注射甲泼尼龙,观察组患者在对照组的治疗基础上联合采用异丙托溴铵和沙丁胺醇雾化治疗。治疗3 d后,比较两组患者的临床疗效、肺功能指标、血气指标及不良反应。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者1秒钟用力呼吸容积(FEV1)、FEV1占用力肺活量百分比(FEV1/FVC)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)比较,差异无统计学意义(P>0.05);治疗后观察组患者FEV1、FEV1/FVC、PaO2均高于对照组,PaCO2低于对照组(P<0.05)。两组患者均无严重并发症发生。结论异丙托溴铵、沙丁胺醇雾化吸入联合甲泼尼龙治疗急性加重期COPD的临床效果确切,可以改善患者的肺功能指标和血气指标,且不良反应较少。
Objective To investigate the clinical effects of ipratropium bromide and salbutamol inhalation combined with methylprednisolone in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 98 acute exacerbation COPD patients admitted to Beijing Haidian Hospital from February 2013 to February 2014 were randomly divided into control group and observation group of 49 cases. Patients in the control group received methylprednisolone intravenously on the basis of routine treatment. Patients in the observation group were treated with ipratropium bromide and salbutamol nebulization on the basis of the control group. After 3 days of treatment, the clinical efficacy, pulmonary function, blood gas index and adverse reactions in both groups were compared. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). Before treatment, FEV1, FEV1 / FVC, PaO2 and PaCO2 in the two groups had no significant difference (P> 0.05). After treatment, the FEV1, FEV1 / FVC and PaO2 in observation group were higher than those in control group and PaCO2 was lower than that in control group (P <0.05). No serious complications occurred in both groups. Conclusions The efficacy of ipratropium bromide and salbutamol inhalation combined with methylprednisolone in the treatment of acute exacerbation of COPD is definite. It can improve the pulmonary function and blood gas indexes of patients with less adverse reactions.