Comparison Of High Dose Nebulized Budesonid By Oxygen Drive And Systemic Corticosteroids In The Treatment Of Acute Exacerbations Of COPD

Objective:To evaluate the clinical effects and value of nebulized budesonid by oxygen drive in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:138 patients with acute exacerbations of COPD of FEV1 80%-30% were randomized to divide into four groups without glucocorticoid.The nebulized budesonid group received budesonid nebulized suspension 4 mg every 12 h for 5 d, the prednisolone group was 30 mg prednisolone by mouth every day,the methylprednisolone group received 40 mg methylprednisolone injeeted every day,and group 4 was the control group.All received standard treatment, including antibiotics,bronchodilator,eliminating phlegm,supplemental oxygen and nutritional support. The dyspnea score(cough, wheeze and wheezing sound),spirogram (FEV1,FEV1%/Pred))and arterial blood gas(PaO2,PaCO2) at HO,H24,H72,D5 were measured.The fasting blood-glucose and adverse effect were evaluated at the same time. Date was statistically analyzed by SPSS 17.0 for windows software. Each of 4 groups was demonstrated as x±s.P<0.05 was considered to be of significance.Results:The difference of HO in the age, the dyspnea score, spirogram and arterial blood gas was no singnificant(P>0.05).And the difference of H24 in the dyspnea score, spirogram and arterial blood gas was no singnificant too(P>0.05). The changes of dyspnea score,spirogram and PaCO2 of H72 in the patients with active treatments were greater than the control group(P<0.05).Though the change of PaO2 was higher than the control group,it was not statistically significant(P>0.05).The changes of D5 in the patients with active treatments were much greater than the control group(P<0.05) in dyspnea score, spirogram and arterial blood gas.The difference between the nebulized budesonid group,prednisolone group and methylprednisolone group was no significant(P>0.05).The nebulized budesonid group had less systemic activity than the prednisolone group and methylprednisolone group as the control group.Blood glucose exhibited an upward trend in the prednisolone group and methylprednisolone group.Conelusion:Nebulized budesonid may be an alternative to systemic corticosteroids in thetreatment of acute exacerbations of COPD.