therapeutic effect of glucocorticoid inhalation for pulmonary fibrosis in ards patients

Objective　To observe the effect of glucocorticoid inhalation on the clinical symptoms and pulmonary fibrosis index in ARDS patients. Methods　Fifty-three ARDS patients admitted to ICU of Songjiang District Center Hospital of Shanghai from Dec. 2011 to Jun. 2013 were randomly divided into two groups. Group A (n=29) received conventional therapy, and group B (n=24) was given glucocorticoid inhalation treatment (budesonide, 2 mg, 1/12 h, for 12 days) on the basis of the conventional therapy. The oxygenation index, time of extubation, changes in pulmonary fibrosis index, including collagen Ⅰ(Co Ⅰ), Ⅲ procollagen peptide (PⅢP) and transforming growth factor (TGF-β1) were compared between the two groups, and the incidence of common adverse reactions were analyzed. Results　The oxygenation index of patients in group B was significantly improved on the 15th day compared with group A (P<0.05). There was a significant difference in the level of Co I, PⅢP and TGF-β1 between two groups as measured with enzyme-linked immunosorbent assay (P<0.05). The hormone therapy did not increase adverse effects (P>0.05). Conclusion　A small dose of glucocorticoids introduced by inhalation can improve the oxygenation index and pulmonary fibrosis level without increasing common adverse reactions, suggesting that the inhalation of corticosteroid may be a clinically safe and effective way in patients with ARDS. DOI: 10.11855/j.issn.0577-7402.2014.09.13