摘要
目的探究雾化吸入布地奈德混悬液与静脉滴注甲基强的松龙两种不同给药方式对急性发作期中、重度支气管哮喘患者的临床症状和对气道炎症的影响。方法选取2017-01~2018-05期间我院呼吸内科门、急诊中-重度哮喘急性发作患者76例,随机分为两组:观察组与对照组。两组患者均给予基础治疗,观察组给予布地奈德混悬液雾化吸入,对照组给予甲基强的松龙静脉滴注,比较治疗前后哮喘控制问卷评分、肺功能、痰Eos%。结果两组患者治疗后哮喘控制问卷评分、FEV1、PEF值、痰Eos%优于治疗前;观察组治疗48h后痰Eos%与治疗前相比下降显著;对照组治疗96h后痰Eos%与治疗前相比下降明显;以上比较结果差异均有统计学意义(P<0.05)。两组患者痰Eos%与PEF日间变异率均呈正相关关系。结论雾化吸入糖皮质激素较静脉滴注给药方式更早控制哮喘急性发作患者气道炎症,缩短炎症进程,更有利于肺功能的恢复,且减少患者全身激素的负荷量。临床上面对中-重度哮喘急性发作时,首先可以选择中高剂量的雾化泵给药方式代替以往常用的静脉糖皮质激素给药方式,本研究为哮喘急性发作治疗新方案的制定提供了实验依据。
Objective To investigate the effects of nebulized inhaled budesonide suspension and intravenous infusion of methylprednisolone on clinical symptoms and airway inflammation in patients with moderate to severe bronchial asthma during acute attack.Methods Seventy-six patients with acute respiratory episodes of acute and severe asthma in our hospital from January 2017 to May 2018 were randomly divided into two groups:observation group and control group.The patients in both groups were given basic treatment.The patients were given nebulized budesonide suspension in observation group,and intravenous infusion of methylprednisolone in control group.The asthma control questionnaire score,lung function and sputum eosinophils were compared before and after treatment.Results After 48 h treatment,sputum eosinophils cell counts decreased significantly in observation group compared with that before treatment(P<0.05).After 96 h treatment,sputum eosinophils cell counts decreased significantly in control group compared with that before treatment(P<0.05).There was a positive correlation between sputum eosinophils cell counts and peak expiratory flow(PEF)variation rate in the two groups.Conclusion Compared with intravenous infusion,nebulized inhaled glucocorticoid can early control airway inflammation in patients with acute asthma,shorten the inflammatory process,facilitate the recovery of lung function,and reduce the systemic hormone load of patients.Clinically,medium and high doses of nebulizing pump administration can be selected to replace the commonly used intravenous glucocorticoid administration in acute attacks of moderate to severe asthma.This study provides experimental basis for the formulation of new treatment plans for acute attacks of asthma.
作者
赵雅婷
张焕萍
ZHAO Yating;ZHANG Huanping(Department of Respiratory and Critical Disease Medicine,First Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《山西医科大学学报》
CAS
2019年第6期789-793,共5页
Journal of Shanxi Medical University
基金
山西省回国留学人员科研资助项目(2016-116)
关键词
支气管哮喘
雾化吸入
痰嗜酸粒细胞
bronchial asthma
aerosol inhalation
sputum eosinophils
作者简介
赵雅婷,女,1992-08生,在读硕士,E-mail:921233001@qq.com;通讯作者:张焕萍,E-mail:zhp326@163.com.
