目的 探讨外周血嗜酸性粒细胞高低对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)是否应用激素的指导价值。方法 收集2016-01至2017-10在医院呼吸科住院的慢性阻塞性肺疾病急性加重患者224例,根据外周血嗜酸性粒细胞是否升高及是否采用激素治疗。分成4组:血EOS增高激素治疗组(1组),血EOS正常激素治疗组(2组),血EOS增高非激素治疗组(3组),血EOS正常非激素治疗组(4组)。收集患者性别、年龄、合并症、CAT评分、血气分析、肺功能及一氧化氮呼气试验。4组均给予吸氧,抗炎,平喘及化痰等一般治疗外,1组及2组加用激素治疗,治疗1周后复查,对4组的FENO、评估CAT评分;计算住院时间及出院3个月后再住院率。结果 4组年龄、性别、血气分析,血红蛋白等方面差异无统计学意义,4组治疗前后FENO及血EOS存在统计学差异(P＜0.05)。平均住院时间及3个月再住院率方面, 1组患者平均住院时间最短,且3个月再住院率均低于其他3组,差异具有统计学意义(P＜0.05)。结论 外周血嗜酸性粒细胞增高的慢性阻塞性肺疾病急性加重期患者宜应用激素治疗。
Abstract
Objective To explore the role of peripheral blood eosinophils in the hormone therapy for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 224 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to our hospital between January 2016 and October 2017 were divided into four groups according to the levels of peripheral blood eosinophils and the selection of hormone therapy:the hormone treatment group (group A) with elevated blood EOS, hormone treatment group with normal blood EOS (group B), non-hormone treatment group with elevated blood EOS (group C), and non-hormone treatment group with normal blood EOS (group D). Information about the gender, age, comorbidities, CAT scores, blood analysis, blood gas analysis, lung function, and nitric oxide breath test of these patients was collected. All the four groups were given oxygen, anti-inflammatory and antiasthmatic treatment,phlegm reduction and other general treatments, but Group A and group B additionally received hormone therapy. After one week, the results of blood analysis, FENO and CAT score of all these were reviewed. The length of hospital stay and rehospitalization rate of the four groups 3 months after discharge were recorded. Statistical analysis was conducted. Results There was no statistically significant difference in the general data, blood gas analysis, hemoglobin or lung function between the four groups. The average length of hospital stay was the shortest in group A and the rate of re-hospitalization 3 months after discharge was also the lowest, with statistically significant differences (P<0.05). Conclusions Peripheral blood eosinophils are of great importance in the hormone therapy for acute exacerbation of chronic obstructive pulmonary disease.
关键词
慢性阻塞性肺疾病急性加重 /
嗜酸性粒细胞 /
激素治疗 /
再住院率
Key words
acute exacerbation of chronic obstructive pulmonary disease /
eosinophils /
hormone therapy /
rehospitalization rate
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参考文献
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