目的 探討福多司坦聯(lián)合布地奈德治療慢性阻塞性肺疾病急性加重期（AECOPD）的臨床療效。方法 選取2016年8月-2017年8月在徐州市中心醫(yī)院進(jìn)行治療的AECOPD患者106例，隨機(jī)分為對(duì)照組（53例）和治療組（53例）。對(duì)照組霧化吸入吸入用布地奈德混懸液，1 mg/次，3次/d；治療組在對(duì)照組的基礎(chǔ)上口服福多司坦片，0.4 g/次，3次/d。兩組均經(jīng)過(guò)2周治療。觀察兩組的臨床療效，比較治療前后兩組患者動(dòng)脈血?dú)庵笜?biāo)、肺功能指標(biāo)、血清炎性指標(biāo)以及氧化應(yīng)激水平。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為81.13%、94.34%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者氧分壓（pO₂）、氧飽和度（SaO₂）水平均明顯升高，二氧化碳分壓（pCO₂）水平降低，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述指標(biāo)改善優(yōu)于對(duì)照組（P<0.05）。治療后，兩組第一秒用力呼出量（FEV₁）、用力肺活量（FVC）、PEF均顯著升高（P<0.05）；且治療組上述指標(biāo)比對(duì)照組改善更明顯（P<0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、可溶性髓系細(xì)胞觸發(fā)受體-1（sTREM-1）、肺表面活性蛋白D（SP-D）水平明顯降低，白細(xì)胞介素-2（IL-2）、干擾素-γ（IFN-γ）水平明顯增加，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述血清炎性指標(biāo)改善程度明顯優(yōu)于對(duì)照組（P<0.05）。治療后，兩組血清總氧化態(tài)（TOS）水平明顯降低，總抗氧化態(tài)（TAS）和對(duì)氧磷酶-1（PON1）水平明顯增高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述指標(biāo)改善后水平明顯好于對(duì)照組（P<0.05）。結(jié)論 福多司坦片聯(lián)合布地奈德治療慢性阻塞性肺疾病急性加重期效果明顯，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of fudosteine combined with budesonide in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Patients (106 cases) with AECOPD in Xuzhou Central Hospital from August 2016 to August 2017 were randomly divided into control (53 cases) and treatment (53 cases) groups. Patients in the control group were atomization inhalation administered with Budesonide Suspension for inhalation, 1 mg/time, three times daily. Patients in the treatment group were po administered with Fudosteine Tablets on the basis of the control group, 0.4 g/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, arterial blood gas indexes, pulmonary function, serological indexes and oxidative stress levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 81.13% and 94.34%, respectively, and there were differences between two groups (P<0.05). After treatment, the pO₂ and SaO₂ in two groups was significantly increased, but the pCO₂ was significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the improvement of these indexes in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the FEV₁, FVC, PEF in two groups were significantly increased (P<0.05). And the improvement of these indicators in the treatment group was more significant than that in the control group (P<0.05). After treatment, the hs-CRP, sTREM-1 and SP-D levels in two groups were significantly decreased, but IL-2 and IFN-γ levels were significantly increased, and there were differences in the same group (P<0.05). And the serological indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the TOS level in two groups was significantly decreased, but the TAS and PON1 level was significantly increased, and the difference was statistically significant in the same group (P<0.05). And the improvement level of these indexes in the treatment group was significantly better than that in the control group (P<0.05). Conclusion Fudosteine combined with budesonide has significant effect in treatment of AECOPD, which has a certain clinical application value.