A randomized, controlled multicentric study of inhaled budesonide and intravenous methylprednisolone in the treatment on acute exacerbation of chronic obstructive pulmonary disease

被引：39

作者：

Ding, Zhen ^{[1
]}

Li, Xiu ^{[1
]}

Lu, Youjin ^{[2
]}

Rong, Guangsheng ^{[3
]}

Yang, Ruiqing ^{[4
]}

Zhang, Ruixia ^{[5
]}

Wang, Guiqin ^{[6
]}

Wei, Xiqiang ^{[7
]}

Ye, Yongqing ^{[8
]}

Qian, Zhaoxia ^{[9
]}

Liu, Hongyan ^{[2
]}

Zhu, Daifeng ^{[3
]}

Zhou, Ruiqing ^{[4
]}

Zhu, Kun ^{[5
]}

Ni, Rongping ^{[6
]}

Xia, Kui ^{[7
]}

Luo, Nan ^{[8
]}

Pei, Cong ^{[10
]}

机构：

[1] Anhui Med Univ, Hefei Peoples Hosp 1, Dept Resp Med, Hosp 3, Huaihe Rd 390, Hefei 230061, Anhui, Peoples R China

[2] Anhui Med Univ, Hosp 2, Dept Resp Med, Hefei, Anhui, Peoples R China

[3] Hefei 3rd Peoples Hosp, Dept Resp Med, Hefei, Anhui, Peoples R China

[4] Chaoyang Hosp, Dept Resp Med, Huainan, Anhui, Peoples R China

[5] Dongfang Hosp, Dept Resp Med, Huainan, Anhui, Peoples R China

[6] Fuyang Peoples Hosp, Dept Resp Med, Fuyang, Anhui, Peoples R China

[7] Huaibei Ist Peoples Hosp, Dept Resp Med, Huaibei, Anhui, Peoples R China

[8] Luan Ist Peoples Hosp, Dept Resp Med, Luan, Anhui, Peoples R China

[9] Bengbu 3rd Peoples Hosp, Dept Resp Med, Bengbu, Anhui, Peoples R China

[10] Hefei Binhu Hosp, Dept Resp Med, Hefei, Anhui, Peoples R China

来源：

RESPIRATORY MEDICINE | 2016年 / 121卷

关键词：

Chronic obstructive pulmonary disease; Exacerbation; Inhaled corticosteroid; Systemic corticosteroid; CONTROLLED-TRIAL; OXYGEN-THERAPY; COPD; MANAGEMENT; PHARMACOKINETICS; CORTICOSTEROIDS; OSTEOPOROSIS; INFLAMMATION; PREVENTION; ASTHMA;

D O I：

10.1016/j.rmed.2016.10.013

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background: Almost all international guidelines recommend corticosteroids for management of exacerbations of chronic obstructive pulmonary disease (COPD), because it leads to improved outcomes of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Nevertheless, due to its side effects, there are still concerns regarding the use of systemic corticosteroid (SC). Inhaled corticosteroids (IC) can be used as an alternative to SC, while reducing the risk of occurrence of side effects. Purpose: To measure the clinical efficacy and side effects of nebulized budesonide and systemic methylprednisolone in AECOPD. Methods: Valid data from 410 AECOPD patients in 10 hospitals was collected. Patients were randomly divided into 2 groups; budesonide group, treated with nebulized budesonide (2 mg 3 times/day); and methylprednisolone group, treated with intravenously injected methylprednisolone (40 mg/day). COPD assessment test (CAT), arterial blood gas analysis, hospitalization days, adverse effects, fasting blood glucose, serum creatinine, alanine aminotransferase levels, and blood drug were measured and analyzed in both groups. Results: Symptoms, pulmonary function and arterial blood gas analysis were significantly improved after treatment in both groups (P < 0.05), with no significant differences between them (P > 0.05), while incidence of adverse events in the budesonide group was lower (P < 0.05). No significant differences in CAT score, days of admission, blood gas analysis results and physiological and biochemical indexes were found between the two groups. Patients treated with methylprednisolone showed a higher degree of PaO2 level improvement. Conclusion: Results show that inhalation of budesonide (2 mg 3 times/day) and systemic methylprednisolone (40 mg/day) had similar clinical outcome in AECOPD. In conclusion, inhaled budesonide is an alternative to systemic corticosteroids in AECOPD treatment. (C) 2016 Elsevier Ltd. All rights reserved.

引用

页码：39 / 47

页数：9

共 37 条

[1]

The clinical management in extremely severe COPD [J].