甲泼尼龙序贯治疗哮喘重度急性发作的临床研究

摘要

Objective Comparative systemic hormone treatment,evaluation of methylprednisolone/fluticasone propionate local sequential treatment of severe acute episode of asthma treatment.Methods Selected severe acute asthma were 52 cases.28 were divided into Group A and Group B were 24.Both groups were given intravenous methylprednisolone80 mg bid×3 d.A group sequential oral methylprednisolone tablets 16 mg qd×5 d.Group B sequential oral methylprednisolone tablets8 mg×2 d At the same time,inhaled salmeterol/fluticasone propionate 50 μg/250 μg,bid×5 d.Results Intravenous treatment of the 3 days,2 indicators comparison group were significantly improved after the sequential therapy was further improved.To 8 days,A group of PEFR value from the pre-treatment of 186 ± 92 L/min,rose to 321±102 L/min(P<0.05),FEV1 from 1.32±0.43 L,rose to 1.87 ± 0.52 L(P<0.05).Group B of the PEFR values from 192±88 L/min,rose to 335 ± 115 L/min,FEV1 from 1.41±0.39 L,rose to 1.93 ± 0.72 L(P<0.05).Between the two groups showed no significant difference(P>0.05).Sputum eosinophil count by 0.45% ±1.3; 0.51% ±1.9 after treatment decreased to 0.07% ±2.8; 0.04% ±0.1,between the two groups showed no significant difference(P>0.05)Conclusion Severe acute asthma attack oral application or inhalation of similar efficacy and safety of hormone possible.%目的 评价甲泼尼龙局部序贯治疗哮喘重度急性发作的疗效.方法 入选急性重度哮喘52例,随机分成A组28例与B组24例,两组均给于甲泼尼龙80 mg,静脉滴注2次/d,用3 d,A组序贯口服甲泼尼龙片16 mg,1次/d,用5 d,B组序贯口服甲泼尼龙片8 mg用2 d同时吸入沙美特罗/丙酸氟替卡松50 μg/250 μg,2次/d,用5 d.结果 静脉治疗第3天后,两组各项指标组内比较均明显改善,序贯治疗后则进一步改善.至第8天,A组的PEF值分别由治疗前的(186±92)L/min,上升至(321±102)L/min(P<0.05),FEV1由(1.32±0.43)L,上升至(1.87±0.52)L(P<0.05). B组的PEF值由(192±88)L/min,上升至(335±115)L/min,FEV1由(1.41±0.39)L,上升至(1.93±0.72)L(P<0.05).两组组间比较无显著差异(P>0.05).A、B两组痰嗜酸细胞计数分别由(0.45%±1.3);(0.51%±1.9)减少至治疗后(0.07%±2.8);(0.04%±0.1),两组间比较无显著差异(P>0.05).结论 对哮喘重度急性发作应用口服或吸入激素疗效相似且安全可行.