雾化吸入布地奈德治疗重度慢性阻塞性肺疾病急性加重中的作用

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1、雾化吸入布地奈德治疗重度慢性阻塞性肺疾病急性加重中的作用?B?1002-0179(2008)03-0519-02?B?S?1?X?q?vNebulizedBudesonideintheTreatment?4?v?C?v?I?PofAcuteExacerbationsofChronicObstructivePulmonaryDisease?a,?3,?2?,?mLIYan-wu,XUZhi-bo,BAOYong,etal.(?b?L?(?u?4?,?b?X?610031)(TheThirdPeoplefnsHospitalofChengduCity,ChengduSichuan610031,Ch

2、ina)X?X?:?:?1?X?q?B?v?4?v?C?v?m?2?.?P?FX?:?(?COPD?C?v?m?2150?;?-3?,?1?X?q?1?X?q?B?2mg?B?S?,?8h1?A;?0?Z?;?Z?;?40mg?(?,?y1?A;?5?P?P?fX?m?;48hX7dX?:?1?X?q?X?Z?;?,FEV1XPaO2XPaCO2?:?F?(?<?v?(P<0105);?1?X?q?X?Z?;?x?0?7?7?:?)?F(P>0105),?#?1?X?q?P?N?<?Z?;?(P<0105)X?:?B?1?X?q?(?q?:?AECOPD?z?j?

3、,?q?N?0?Z?;?F,?P?e,?;?P?f?(?X?Y?:?v?4?v?;?1?X?q?;?S?;?Z?;?I?-?R563X?X?X?Y?7?AX?X?Abstract:Objective:Toevaluatetheclinicalefficacyofnebulizedbudesonide(NB)inacuteexacerbationsofchronicob2structivepulmonarydisease(COPD).Methods:Patientswererandomlydividedintothreegroups.TheNSgroupreceivednebu2lizedbud

4、esonidebyexacerbationwith2mgevery8h.Theprednisolonegroupwastreatedwith40mgbyintravenouseveryday.Theplacebowasofferedcommontreatmentandnottreatedwithadrenocorticalhormones.Allgroupswereobservedfor48hand7d.Results:BothbudesonideandprednisoloneimprovedinFEV1XPaO2andPaCO2wwhencomparedwithplacebo(P<01

5、05).ThedifferenceinFEV1XPaO2XPaCO2betweenbudesonideandprednisolonewasnotsignificant(P>0105).Theoccurrenceofseri2ousadverseintheNSgroupwerelowerthanthePSgroup(P<0105).Conclusion:BothbudesonideandprednisoloneimprovedobstruentairflowinCOPDpatientsNebulizedbudesonidemaybeanalternativetointravenous

6、prednisoloneinthetreatmentofnonacidoticexacerbationsofCOPDwithloweradverseevents.Keywords:acuteexacerbationofchronicobstructivepulmonarydisease;budesonidesuspension;inhalation;prednisolone(Receiveddate:2007-12-10)?11(?)?H/?)(?)FEV1%PaO2mmHgPaCO2mmHgNS?6315?81732/181019?8153912?8175011?13194916?1213P

7、S?6412?61434/161110?5153715?7154918?12145019?1110?6317?91932/181016?6193711?7115211?10195011?1119P>0105>0105>0105>0105>0105>0105?21FEV1%XFVC%XPaO2XPaCO2?D2D7FEV1%NS?PS?3912?8173715?7153711?7114313?12133#3911?141933715?13124610?13193#4416?141133814?1412PaO2mmHgNS?PS?5011?13194918?12

8、145211?10195715?13163#5913?101935315?12116112?14133#6111?121935612?1214PaCO2mmHgNS?PS?4916?12135019?11105011?11194611?9193#4814?91934917?11144019?10153#4117?91934915?918?:?N?:3P<0105;?NPS?:#P>0105?31NS?XPS?N?P?R?5?%?R?pNS?501(2%)2(4%)1(2%)1(2%)PS?508(16%)36(12%)34(8%)31(2%)?:?NNS?:3P<0105X?

9、2?a(6),?,?b?,?4?4?9,?4?XX?3(COPD)?w?vX?b?v?XCOPD?2?C?v?A?1?4?A1,?2?BX?)?X?m?4?P?)?,?C?v?m?S?X2006?COPD?Z?1?A?(GOLD?q)?7?COPD?C?v?m?2?m?P?P?f?:?,?y?5?,?u?5?,?m?4?P?,?P?z?(FEV1)<50%?F?5?C?v?COPD?2?P2X?#?f?5?P?X?p,?z?.?COPD?t?;?,?S?9?,?,?w?P?f?i?,?3?m?4?P?)?,?4?:?P?3X?,?.?8?P?f?X?B?1?X?q?P?.?(?j?X?4

10、?v?,?v?,?;?S?v?f?P?w?z?COPD?g?m?X?p?3,?B?(?u?z?P?w?z?COPD?C?v?m?P4?9X?:?z?(?5?3,?z?I?P?B?1?X?q?M?1?;?1?8mgX?L?z?P?f?B?S?P?COPD?C?v?m?q?vX1X?111X?(?:?(?2005?5?9?5?9?u?OD?C?v?m?25?,?I?H?,?5?,?G?6318?813?,?50?X?(?7?:(1)?O?9COPD?C?v?m?7?10,(2)1s?P?4?(FEV1)<50%?3c?30%,(3)?R?z?-?;?I?,(4)?2X?7?:(1)?;?w?

11、z?,(2)?9?<?;?v?,(3)?m?P?P?f?B3?y?P?P?f,()?,?C?>?(?f?P?,(5)?,?5?k?e?C?,(6)?9?S?;?t?zX112X?N?:?P?SEN2SORMEDICS6200?W?,?1?X?q?B?(?#?5:?W?l,AstraZeneca?m?)2mg?B?S?(?PPARIBOYN?s?y?B?S?;,?(?m?),?0?P?Z?F?C?(?#?5?Z?;?,?m?)?(?qX13X?-?;?-?B?1915?4?2008,23(3)X?CN51-1356/R:197-:2007CP1098204tid:40mgd1:(NS

12、)?X?0?Z?;?(PS)?3?,?-?(?)?q?P?,NS?1?X?q?B?2mg?B?S?,?y?(?A;PS?Z?;?40mg/?y;?5?P?P?fX?m?;7?y,?m?(GOLD?q?w?z?f?MX?m?fX?X?v?k?S?,?#?5?P?P?fX?R?(?-?,?P?(?X?N48hX7d?(?R?z?-?w?z?f?M?P?N?W?X?(?R?z?-?2?R?v?-?(PaO2)X?(?v?B?-?(PaCO2),?7?7?P?z?(FEV1)?BX?m?v?,?P?f?P,?2?m?R?(?.?SX?t?-?X?L?4?O?-?t?,?p?0?5?C?q,?(?3?e

13、?X2X?211X?150?2?L?-?,?0?-,P>0105X?(?P?X?)XFEV1%?R?z?-?(?v(?1)X212X?N?5?P?f?,NS?PS?(?R?z?7?7?5?XPS?NS?(?v?-?(PaO2)?P?z?(FEV1)?G?<?p,?x?NFEV1?PaO2?G?(?N?<?:?(P<0105),?x?0?7?7?P?0?:?)?F(P>0105),Pa2CO2?F?:?)?FX?1?X?q?2mg/?AX?y?(?A?S?q?N?0?Z?;?40mg/?y?,?4?7?7FEV1%XPaO2XPaCO2?F?P?)?0?N?(?&l

14、t;?v(?2)X213X?(?0?P?f?5?t?S?f?(?3)X3X?COPD?C?v?m?4?2?w?z?f?MX?m?k?(?(?m?)?P?P?f?kX?PCOPD?C?v?m?2?I?z?I?v?,?U?P?.?G?,?2?x?1?(TNF-1?),?(?B4(LTB4)?f8(IL-8)?k,?P?f?N?COPD?C?v?m?2?z?I?v?TNF-1?XLTB4XIL-8?k?P?.?)?2X?-COPD?C?v?2?P?z?v?v?,?t?w?z?4?,?PCOPD?C?v?m?z?v?COPD?g?m?30?511,?B,?v?g?(ECP)?,?N?<?COPD

15、?g?mX?PCOPD?C?v?m?8?)?-?T?-?4?B?(RANTES)?<?8?1,?zRANTES?N?4?v?b?12X?8?P?f?P?COPD?C?v?I?PX?L?z?<?;,?N?5?P?f?,NS?PS?(?R?z?7?7?5?,?N?f?(?qX?NM?k,?z?FX?t?4?z?N,?P?P?f?OD?C?v?m?2?,?5,?:?v?R?,?m?5?U?C?,?y?k13,14X?p?3,?P?P?f?5?w?<?3?i?XNiewoehner?k14?J,AECOPD?2?P?F?30mg,2?N?R?G?X?>?k?5?<?X?v

16、?P?P?f?P?COPD?C?v?m?/?p?w?(?C?COPD?2?w?3?(?X?)?I?.?(?t?,?S?m?P?v?P?f15-19X?P?f?5?N?2?R?P?w?M?(?X?w?M?w?P?P?f?P?I?f8,20,21X?P?v?P?f?5?P?H?(?,?m?5?P?2?m?P?N?<?X?P?f?d?C?N?<?2?m?P?w?X?,?v?P?P?f?P?COPD?C?v?m?m?/?p?5?X?P?f?B?S?U?P?u,?5?R?3?P?,?q?3?5?u,?S?N?-?S?p?,?#?A?(85?90%?e?,?R?b?c?4?v?,?X?L?&l

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