A step-wise application of methylprednisolone versus dexamethasone in the treatment of acute exacerbations of COPD

被引:17
作者
Li, HP [1 ]
He, GJ [1 ]
Chu, HQ [1 ]
Zhao, L [1 ]
Yu, H [1 ]
机构
[1] Shanghai Pulm Hosp, Shanghai 200433, Peoples R China
关键词
acute exacerbation of COPD; dexamethasone; methylprednisolone;
D O I
10.1046/j.1440-1843.2003.00468.x
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Objective: The aim of the study was to explore the clinical value of a step-wise application of methylprednisolone (MP) compared to dexamethasone (DXM) in acute exacerbations of COPD. Methodology: One hundred and forty-two patients with an acute exacerbation of COPI) were divided randomly into two groups: 71 patients were treated with MP and the other 71 patients were treated with DXM. Otherwise each group was given the same basic treatments: antibiotics, bronchodilators, oxygen therapy as well as standard hospital care. The patients in the MP group were given a tapering dose of MP for 7-14 days, and the patients in the DXM group were given a corresponding tapering dose of DXM for 7-14 days. Then both groups were given a gradually reducing dose of oral prednisone for 2-3 weeks. Two weeks before the prednisone was tapered off, inhaled corticosteroid was introduced. The patients' symptom scores, physical signs, per cent predicted FEV1%, and arterial blood gases were monitored before treatment and after the seventh day of treatment. Results: There was an obvious improvement in symptoms after 1-3 days in all 71 patients in the MP group, with their wheezing being distinctly reduced or disappearing entirely. The maximum benefit that occurred in the MP group (90.14%) was considerably higher than that of the DXM group (25.35%), P < 0.05. The predicted FEV1% in the MP group increased from 46.7 +/- 10.6 to 67.5 +/- 12.4, compared with an increase in the DXM group from 50.1 +/- 7.6 to 58.9 +/- 10.8. The difference between the two groups was significant (P< 0.05). Conclusions: An adequate and tapering dose of MP used in acute exacerbations of COPI) can relieve the inflammatory reaction in airways and reduce airway spasm more promptly than DXM.
引用
收藏
页码:199 / 204
页数:6
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