摘要：目的：探讨氧启动雾化吸入溴化异丙托品、普米克令舒在慢性阻塞性肺疾病急性加重期(AECOPD)治疗中的效果。方法：选取慢性阻塞性肺疾病急性加重期(AECOPD)患者68例，随机分为A、B、C三个方案组，用氧启动雾化吸入治疗，A组21例药物配伍为0.025%溴化异丙托品溶液(爱全乐溶液)2ml加生理盐水2ml雾化吸入，B组23例布地奈德(普米克令舒)2ml加生理盐水2ml雾化吸入，C组24例溴化异丙托品溶液(爱全乐溶液)2ml加布地奈德(普米克令舒)2ml雾化吸入，观察记录雾化吸入前和雾化吸入后72h FVC 和FEV1，雾化吸入药物前后进行血气分析，同时观察不良反应及临床疗效评定。结果：在三组中，A临床症状改善有效率为 66.67% ，B组有效率为65.53%，C组有效率为91.67% ，三组疗效比较，C组较 A组和B组对照，有显著差异(P<0.05)， 三组用药后肺功能测定FEV1, FEV1%和FVC均有明显改善，C组较 A组和B组改善更明显(P<0.05)；血气分析用药前后各组间无明显差异，三组均未见明显不良反应。结论：在慢性阻塞性肺疾病急性加重期患者的治疗中，采用氧启动雾化联合吸入溴化异丙托品、布地奈德效果更好。

    关键词：慢性阻塞性肺疾病；急性加重期；溴化异丙托品；布地奈德；氧启动雾化吸入

    Efficacy of Impratropium Bromide and Budesonide incombination for the Treatment of Chronic Obstructive Pulmonary Disease

    at the Stage of Acute Exacerbation

    CHEN Hong-qun,HUANG Yun-ping，YU Rong-huan,et al

    (Xuhui District Central Hospital , Shanghai 200031， China)

    Abstract： Objective： To appraise the efficacy of impratropium bromide and budesonide incombination for the treatment of chronic obstructive pulmonary disease at the stage of acute exacerbation by oxygen startup atonmization inhalation. Method： 68 cases with acute exacerbation of COPD were randomized into 3 groups.Each group received 2.0ml of inhaled 0.025% impratropium bromide, 2ml budesonide or 2.0ml of inhaled 0.025% impratropium bromide plus 2ml budesonide by oxygen startup atomization inhalation. Lung function and blood gas analysis were assessed before drug administration and thereafter.Result： The effective rate of group C was significantly higher than those of group A and B;All three groups significantly improved in FEV1,FEV1% and FVC. Combination treatment with impratropium bromide and budesonide provided significantly (P<0.05) greater improvements in pulmonary function than Impratropium bromide or Budesonide given alone. Conclusion： Patients with acute exacerbation of COPD may benefit from combination treatment with Impratropium bromide and Budesonide by oxygen startup. ......