摘要
目的探讨糖皮质激素口服及静脉滴注两种给药方式治疗慢阻肺急性加重期(AECOPD)的效果和安全性。方法选取我院2015年10月~2016年12月收治的102例AECOPD患者作为研究对象,采取随机数字表法分为口服给药组与静脉给药组,每组51例。口服给药组给予甲泼尼龙片口服治疗,剂量为32 mg/d;静脉给药组给予甲泼尼龙静脉滴注,第1~3天剂量为1 mg/(kg·d),第4~7天为0.5 mg/(kg·d)。两组在治疗1周后进行疗效评估,同时比较两组用药后的不良反应发生情况。结果两组的临床总有效率比较,差异无统计学意义(P>0.05)。两组治疗后的PaO_2、PaCO_2水平显著优于治疗前,差异有统计学意义(P<0.01)。两组治疗前及治疗后的pH值、PaO_2、PaCO_2水平比较,差异无统计学意义(P>0.05)。两组的消化道反应发生率比较,差异无统计学意义(P>0.05)。口服给药组的血糖升高、血压升高、肺性脑病发生率均显著低于静脉给药组,差异有统计学意义(P<0.05)。结论糖皮质激素口服给药及静脉滴注给药治疗AECOPD均能取得满意效果,但口服给药方式的并发症更少,安全性更高。
Objective To investigate the efficacy and safety of glucocorticoid in oral administration and intravenous infu- sion in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）.Methods A total of 102 patients with AECOPD who were enrolled in our hospital from October 2015 to December 2016 were selected as research objects.They were evenly divided into the oral administration group and the intravenous infusion group according to a random number table method.In the oral administration group,32 mg/d Methylprednisolone was used,while in the intra- venous infusion group,Methylprednisolone via intravenous drip was adopted.The dose in the first three days was 1 mg/（kg· d）, and 0.5 mg/（kg·d） from day 4 to day 7.After one-week treatment,the efficacy was assessed and the occurrence of ad- verse reactions in the two groups was compared.Results There was no significant difference in the total effective rate between the two groups （P〉0.05）.The level of PaO2 and PaCO2 after treatment in the two groups was significantly better than that before treatment,with significant difference （P〈0.01）.There was no significant difference in the level of pH, PaO2 and PaCO2 before treatment and after treatment between the two groups （P〉0.05）.There was no significant differ- ence in the incidence of digestive tract reaction between the two groups （P〉0.05）.The incidence rate of elevated blood glucose,elevated blood pressure,and pulmonary encephalopathy in the oral administration group was significantly lower than that in the intravenous infusion group,with significant difference （P〈0.05）.Conclusion Glucocorticoid both in oral administration and in intravenous infusion obtain satisfactory effect on treating AECOPD,but the oral administration has less complications and higher safety.
出处
《中国当代医药》
2017年第23期46-48,65,共4页
China Modern Medicine
关键词
糖皮质激素
口服给药
静脉滴注
慢性阻塞性肺疾病
急性加重期
Glucocorticoid
Oral administration
Intravenous drip
Chronic obstructive pulmonary disease
Acute exacerbation
