Clinical Effects of Corticosteroids on Systemic Inflammation in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To observe the clinical effects of three types of corticosteroids on systemic inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods One hundred and twenty hospitalized patients with AECOPD were randomly divided into four groups,with 30 patients in each group.All patients were conventionally treated with oxygen,antibiotics and bronchodilators.On this basis,oral corticosteroids group received 30 mg·d-1 of prednisone for 7 days;nebulized corticosteroids group received 4 mg·d-1 of nebulized budesonide twice daily for 7 days;intravenous corticosteroids group received intravenous infusion of 80 mg·d-1 of methylprednisolone twice daily for 7 days;control group only received conventional treatment.The lung functions,arterial blood gas values,C-reactive protein(CRP),body mass index,mid-thigh circumference and symptom scores were measured before and after treatment.Results Compared with control group,corticosteroids treatment increased FEV1 and PaO2,decreased CRP levels,and improved systemic symptoms(P0.05 or P0.01).Compared with intravenous corticosteroids group,FEV1 and PaO2 decreased in oral corticosteroids group and nebulized corticosteroids group(P0.05),but no significant differences were observed between the two groups(P0.05).In addition,body mass index in intravenous corticosteroids group was higher than that in the other three groups(P0.05).There were no significant differences in mid-thigh circumference among the four groups(P0.05).Conclusion The three types of corticosteroids treatment,especially intravenous infusion of methylprednisolone,can effectively reduce systemic inflammation and improve lung functions and clinical symptoms in patients with AECOPD.