Clinical Observation Of Nebulized Budesonide Suspension In Treating Senile Patients With Acute Exacerbations Of Chronic Obstructive Pulmonary Disease

Objectives:To investigate the clinical effect of nebulized budesonide suspension in the treatment of senile patients with acute exacerbations of chronic obstructive pulmonary disease(COPD).To observe the variation of indexes of C-reactive protein(CRP),erythrocyte sedimentation rate (ESR),white blood cell count(WBC),The percentage of neutrophil(N), bacterial culture of sputum,chest radiologic examination in COPD patients of acute aggravate stage before and after the treatment.To study the implication of CRP variation in the exacerbation of COPD.To study the clinical application value of CRP examination in detecting inflammation of patients with COPD of acute aggravate stage treated by glucocorticoids.Methods:From 2005.9 to 2008.1,40 senile patients with acute exacerbations of COPD were randomized to divide in 2 groups.The treatment group has 20 patients,treated with routine cure and nebulized budesonide. The control group has 20 patients too,treated with routine cure only. To observe the changes of decompensation,arterial blood gas(arterial oxygen pressure PaO₂,arterial carbon dioxide pressure PaCO₂),pulmonary function(forced expiratory volume in one second FEV₁,forced vital capacity FVC,FEV₁%FVC,peak expiratory flow rate PEF)before and after the treatment.To record the related side-effects and the variation of blood sugar and blood pressure before and after the treatment.To examine CRP,ESR,WBC,N,bacterial culture of sputum,chest radiologic examination in the two groups before and after the treatment.To compare the positive rate of each index before the treatment and the variation of these indexes before and after the treatment.In our study,all data were expressed as mean±standard deviation((?)±s).Between-group differences were analyzed with t test.Differences before and after treatment were analyzed with paired t test.Comparisons of positive rate were analyzed with x² test,p＜0.05 was considered to be of significance.Results:The two groups had significant differences on dyspnea score, pulmonary function,blood gases after 5-day treatment(p＜0.05).Both groups have no serious side-effects.The difference of blood sugar,blood pressure between two groups was no statistical significant(p＞0.05).The positive rate of CRP was significantly higher than other indexes in the patients with acute exacerbations of COPD(p＜0.05).After the treatment, the date of CRP,ESR and N were decreased significantly(p＜0.05).The number of WBC was increased after glucocorticoids therapy(p＜0.05),and was decreased after non-glucocorticoids therapy(p＜0.05).The level of CRP in acute exacerbation of COPD increased obviously before the treatment,and decreased rapidly after the treatment.The difference was significant(p＜0.05).Conclusion:1.Nebulized budesonide is worth spreading in treating acute exacerbation of chronic obstructive pulmonary disease as a safe and efficient method,which can ameliorate PaO₂,PCO₂,pulmonary function and alleviate clinical symptom.2.Serum CRP level in patients with acute exacerbations of COPD increased significantly.Serum CRP level might reflect the severity of acute exacerbations of COPD and might better than ESR,WBC,N,X-ray,smear and other diagnostic methods.3.CRP is involved in the acute inflammation in COPD which may be index of infection in COPD patients.CRP couldn't be influenced by glucocorticoids,therefore is a sensitive index in detecting inflammation of acute exacerbation of COPD patients treated by glucocorticoids.