Effect of three types of glucocorticoid administration on lung function and inflammatory status of acute exacerbation of chronic obscructive pulmonary disease
XIAO Wen-xiang LI Jing LIU Hong-mei
Department of Pharmacy, CITIC Huizhou Hospital Co., Ltd. CITIC Huizhou Hospital, Guangdong Province, Huizhou 516001, China
Abstract:Objective To investigate the effects of three kinds of Glucocorticoids on pulmonary function and inflammatory status of acute exacerbation of chronic obscructive pulmonary disease (AECOPD). Methods A total of 60 patients with AECOPD admitted to our hospital from September 2018 to October 2019 were selected as the research subjects,according to the random number table method, they were divided into group A (oral Prednisone), group B (intravenous Methylprednisolone), and group C (nebulized inhaled Budesonide), each had 20 cases. All three groups of patients received conventional treatments such as asthma, phlegm and cough relief, oxygen inhalation, nutritional support, and correction of electrolyte balance. Pulmonary function [forced expiratory volume in 1 second (FEV1), forced vital capacity(FVC), FEV1/FVC], serum inflammatory cytokines [tumor necrosis factor-α (TNF-α), C-reactive protein level (CRP) ]levels, the occurrence of adverse reactions were compared. Results There were no statistically significant differences in the levels of FEV1, FVC, and FEV1/FVC before treatment (P>0.05). After 5 days of treatment, the levels of FEV1, FVC,and FEV1/FVC in the three groups were higher than those before treatment, and the difference were statistically significant (P<0.05). The FEV1, FVC, FEV1/FVC levels in group B were higher than those in group C, the differences were statistically significant (P<0.05). Ther was statistically significant difference in the above indicators of three groups (P<0.05). The levels of serum TNF-α and CRP in the three groups before and after treatment were not statistically significant (P>0.05); after 5 days of treatment, the levels of serum TNF-α and CRP in the three groups were lower than those before treatment (P <0.05). After 5 days of treatment, the total incidence of adverse reactions in groups A and B(40.00%, 35.00%) were higher than that in group C (5.00%), the differences were statistically significant (P<0.05); adverse reactions in three groups, the difference in total incidence was statistically significant (P<0.05). Conclusion Both intravenous drip therapy with Methylprednisolone and atomized inhalation therapy with Budesonide can effectively improve the lung function of AECOPD patients, reduce patients′ serum inflammatory factor levels, however, but the safety of Budesonide atomization inhalation therapy is higher.
肖文香;李静;刘红梅. 三种给药方式的糖皮质激素对慢性阻塞性肺疾病急性加重期患者肺功能及炎性指标的影响[J]. 中国当代医药, 2020, 27(19): 50-53.
XIAO Wen-xiang;LI Jing;LIU Hong-mei. Effect of three types of glucocorticoid administration on lung function and inflammatory status of acute exacerbation of chronic obscructive pulmonary disease. 中国当代医药, 2020, 27(19): 50-53.
Moretti M,Fagnani S.Erdosteine reduces inflammation and time to first exacerbation postdischarge in hospitalized patients with AECOPD[J].Int J Chron Obstruct Pulmon Dis,2018,15(2):235-235.
Taniguchi A,Miyahara N,Oda N,et al.Protective effects of bisoprolol against acute exacerbation in moderate-to-severe chronic obstructive pulmonary disease[J].Acta Med Okayama,2017,71(5):453-457.
Stefan MS,Pekow PS,Shieh MS,et al.Hospital volume and outcomes of noninvasive ventilation in patients Hospitalized with an acute exacerbation of chronic obstructive pulmonary disease[J].Crit Care Med,2016,45(1):20-27.
Morantes-Caballero JA,Fajardo Rodriguez HA.Effects of air pollution on acute exacerbation of chronic obstructive pulmonary disease: a descriptive retrospective study (pol-AECOPD)[J].Int J Chron Obstruct Pulmon Dis,2019,14(2):1549.
[10]
Myers LC,Faridi MK,Currier P,et al.ICU utilization for patients with Acute exacerbation of chronic obstructive pulmonary disease receiving noninvasive ventilation[J].Crit Care Med,2019,47(5):677-684.