Abstract: Objective To investigate the effect of fludostane combined with budesonide on the levels of serum soluble myeloid cell trigger receptor-1 (strom-1), pulmonary surfactant protein D (SP-D), interferon-γ (IFN-γ) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods 80 patients with AECOPD admitted to our hospital from June 2016 to December 2019 were selected as the study objects. According to the random number table method, patients were divided into observation group and control group, 40 cases in each group. The patients in the two groups received routine treatment, the control group was treated with fludostame, and the observation group was treated with budesonide on the basis of the control group. The pulmonary function (FEV1, PEF, FEV1/FVC) and inflammatory indexes of the two groups before and after treatment were compared, and the adverse reactions of the two groups were compared. Results After treatment, FEV1, PEF and FEV1 / FVC in the observation group were higher than those in the control group, with a statistically significant difference (P< 0.05); SP-D and strom-1 levels in the observation group were lower than those in the control group, and IFN-γ levels were higher than those in the control group, with a statistically significant difference (P < 0.05); there was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion The combination of fludostane and budesonide in the treatment of AECOPD patients has a significant clinical effect,which can effectively reduce the inflammatory response, improve the pulmonary function of patients, and has a certain degree of safety.

Key words: chronic obstructive pulmonary disease, acute exacerbation, fordostan, budesonide, inflammatory index, pulmonary function

摘要： 目的 探讨福多司坦结合布地奈德对急性加重期慢性阻塞性肺疾病（AECOPD）患者血清可溶性髓系细胞触发受体-1（sTREM-1）、肺表面活性蛋白D（SP-D）、干扰素-γ（IFN-γ）水平的影响。方法 选择2016年6月~2019年12月我院收治80例AECOPD患者作为研究对象,按照随机数表法分为观察组与对照组,每组各40例。两组患者均接受常规治疗,对照组加用福多司坦治疗,观察组在对照组基础上加用布地奈德治疗。对比两组治疗前后肺功能[1s用力呼吸量（FEV1）、最大呼吸流量（PEF）、第1秒用力呼气量占用力肺活量的比值（FEV1/FVC）]与炎性指标水平,同时比较两组患者不良反应发生情况。结果 治疗后,观察组FEV1、PEF、FEV1/FVC值较对照组高,差异有统计学意义（P<0.05）;观察组SP-D、sTREM-1水平较对照组低,IFN-γ水平较对照组高,差异有统计学意义（P<0.05）;两组不良反应发生率相比,差异无统计学意义（P>0.05）。结论 福多司坦与布地奈德结合治疗AECOPD患者具有显著的临床效果,可有效减轻炎症反应,提高患者肺功能,且具有一定的安全性。

关键词: 慢性阻塞性肺疾病, 急性加重期, 福多司坦, 布地奈德, 炎性指标, 肺功能