目的 探讨福多司坦联合布地奈德治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效。方法 选取2016年8月-2017年8月在徐州市中心医院进行治疗的AECOPD患者106例，随机分为对照组（53例）和治疗组（53例）。对照组雾化吸入吸入用布地奈德混悬液，1 mg/次，3次/d；治疗组在对照组的基础上口服福多司坦片，0.4 g/次，3次/d。两组均经过2周治疗。观察两组的临床疗效，比较治疗前后两组患者动脉血气指标、肺功能指标、血清炎性指标以及氧化应激水平。结果 治疗后，对照组和治疗组的总有效率分别为81.13%、94.34%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者氧分压（pO₂）、氧饱和度（SaO₂）水平均明显升高，二氧化碳分压（pCO₂）水平降低，同组比较差异具有统计学意义（P<0.05）；且治疗组上述指标改善优于对照组（P<0.05）。治疗后，两组第一秒用力呼出量（FEV₁）、用力肺活量（FVC）、PEF均显著升高（P<0.05）；且治疗组上述指标比对照组改善更明显（P<0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）、可溶性髓系细胞触发受体-1（sTREM-1）、肺表面活性蛋白D（SP-D）水平明显降低，白细胞介素-2（IL-2）、干扰素-γ（IFN-γ）水平明显增加，同组比较差异具有统计学意义（P<0.05）；且治疗组上述血清炎性指标改善程度明显优于对照组（P<0.05）。治疗后，两组血清总氧化态（TOS）水平明显降低，总抗氧化态（TAS）和对氧磷酶-1（PON1）水平明显增高，同组比较差异具有统计学意义（P<0.05）；且治疗组上述指标改善后水平明显好于对照组（P<0.05）。结论 福多司坦片联合布地奈德治疗慢性阻塞性肺疾病急性加重期效果明显，具有一定的临床推广应用价值。

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.