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两种糖皮质激素给药方案治疗老年AECOPD患者的临床观察
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| 篇名： | 两种糖皮质激素给药方案治疗老年AECOPD患者的临床观察 |
| TITLE： | |
| 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（P＞0.05）。 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（P＞0.05）。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（P＜0.05），但组间比较差异无统计学意义（P＞0.05）。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（P＜0.05）。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（P＜0.05）。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 and safety of 2 kinds of glucocorticoid administration regimens including 5 d and 15 d on clinical efficacy， pulmonary function， quality of life in elderly patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. METHODS： A total of 160 elderly patients with AECOPD selected from Haikou Forth People’s Hospital during May 2013-Dec. 2015 were divided into group A and B according to lottery method， with 80 cases in each group. Both groups received symptomatic treatment as eliminating phlegm and relieving asthma， controlling infection， etc. Based on it， group A was given Methylprednisolone sodium succinate for injection， 40 mg/d for 15 d； group B was given Methylprednisolone sodium succinate for injection， 40 mg/d for 5 d. Clinical efficacies were compared between 2 groups as well as the levels of pulmonary ventilation function indexes， blood gas analysis indexes， Spitzer life quality index scale （QLI） scores before and after treatment. The occurrence of ADR was also compared between 2 groups. RESULTS： Total response rate of group A was 92.50％， and that of group B was 90.00％， without statistical significance （P＞0.05）. Before treatment， there was no statistical significance in the levels of pulmonary ventilation function indexes， blood gas analysis indexes， QLI scores between 2 groups （P＞0.05）. After treatment， FVC， FEV1， FEV1％ and PaO2 of 2 groups were significantly higher than before treatment， while PaCO2 was significantly lower than before treatment， with statistical significance （P＜0.05）； there was no statistical significance between 2 groups （P＞0.05）. QLI scores of 2 groups were significantly higher than before treatment， and the group B was significantly higher than the group A， with statistical significance （P＜0.05）. The incidence of ADR in group B （6.25％） was significantly lower than group A （22.50％）， with statistical significance（P＜0.05）. CONCLUSIONS： Glucocorticoid administration regimen including 5 d and 15 d in the treatment of elderly patients with AECOPD possess the same effects in improving lung function； glucocorticoid administration regimen for 5 d application is superior in effectively improving the quality of life of patients， reducing the risk of ADR， and has clinical value. |
| 期刊： | 2017年第28卷第14期 |
| 作者： | 吴胜，饶平，吴清松 |
| AUTHORS： | WU Sheng，RAO Ping，WU Qingsong |
| 关键字： | 糖皮质激素；慢性阻塞性肺疾病急性加重期；老年患者；肺功能；生活质量；药品不良反应 |
| KEYWORDS： | Glucocorticoid； Acute exacerbation of chronic obstructive pulmonary disease； Elderly patients； Pulmonary function； Quality of life； Adverse drug reaction |
| 阅读数： | 260 次 |
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