Clinical trial of budesonide inhalation aerosol in the treatment of patients with AECOPD complicated with type Ⅱ respiratory failure
Objective To observe the clinical efficacy and safety of budesonide inhalation aerosol combined with non-invasive positive pressure ventilation(NIPPV)in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)combined with typeⅡ respiratory failure.Methods According to cohort method,patients with AECOPD and type Ⅱ respiratory failure were divided into treatment group and control group.The control group was given NIPPV(4 h/once,tid),while treatment group was given budesonide inhalation aerosol(344 μg/once,bid)on basis of control group.All patients were treated for 4 weeks.The clinical curative effect,disease severity,respiratory,pulmonary function indexes[peak expiratory flow(PEF),forced expiratory volume in one second(FEV1),vital capacity(VC)],serum inflammatory factors[interleukin(IL)-17,IL-6,soluble intercellular adhesion molecule(sICAM)-1]were compared,and evaluated the safety.Results There were 38 cases in control group and 42 cases in treatment group.After treatment,total response rates in treatment group and control group were 92.86％(39 cases/42 cases)and 76.32％(29 cases/38 cases),and the difference was significant(P＜0.05).After treatment,scores of COPD assessment test(CAT)in treatment group and control group were(9.61±1.86)and(15.23±2.45)points;scores of modified british medical research council respiratory questionnaire(mMRC)were(1.74±0.31)and(2.43±0.35)points;PEF were(374.63±30.42)and(345.82±26.34)L·min-1;FEV,were(1.59±0.40)and(1.30±0.33)L;VC were(2.64±0.64)and(2.07±0.56)L;levels of serum IL-17 were(67.03±8.21)and(80.79±10.49)μg·L-1;IL-6 levels were(14.86±3.75)and(20.42±4.39)ng·L-1;sICAM-1 levels were(118.63±17.72)and(156.42±24.38)ng·mL-1,and the differences were statistically significant(all P＜0.05).In treatment group,adverse drug reactions were mainly on palpitation,dizziness and dry mouth,while which were mainly on dizziness,dry mouth and nausea in control group.There was no significant difference in total incidence of adverse drug reactions between treatment group and control group[9.52％(4 cases/42 cases)vs 7.89％(3 cases/38 cases),P＞0.05].Conclusion Budesonide inhalation aerosol combined with NNIPPV can effectively control disease severity,relieve dyspnea,improve pulmonary function and alleviate inflammatory response in patients with AECOPD and type Ⅱ respiratory failure,which has good safety.
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