口服糖皮质激素对于不同部位肺气肿的疗效  

The effect of oral glucocorticoids in different parts of emphysema

作　　者：杜月君 曾嘉涛[1] Du Yuejun;Zeng Jiatao(Department of Respiratory Medicine,Chengdu Second People's Hospital,Chengdu 610015,China)

机构地区：[1]成都市第二人民医院呼吸科,610015

出　　处：《国际呼吸杂志》2018年第24期1888-1891,共4页International Journal of Respiration

摘　　要：目的 探讨口服糖皮质激素对于不同部位肺气肿的疗效。方法 随机选取2016年1~12月成都市第二人民医院呼吸科口服糖皮质激素的慢性阻塞性肺疾病急性加重期 (AECOPD)住院患者80例为激素组,选取40例同期未给予糖皮质激素治疗的AECOPD患者为对照组,比较口服糖皮质激素治疗前后2组患者改良版英国医学研究会呼吸问卷 (mMRC)及慢性阻塞性肺疾病评估测试(CAT)变化。根据胸部高分辨率CT检查结果将激素组患者分为上叶为主肺气肿组和下叶为主肺气肿组,比较口服糖皮质激素治疗前后该2组患者 mMRC及CAT变化。结果 激素组与对照组患者入院时mMRC、CAT、白细胞 (WBC)、C反应蛋白 (CRP)比较,差异均无统计学意义;治疗5d后2组患者 mMRC、CAT、CRP比较,差异均有统计学意义 (t值分别为5.681、2.234、3.238,P 值均<0.05)。上叶为主肺气肿组与下叶为主肺气肿组入院时 mMRC、CAT、WBC、CRP比较,差异均无统计学意义;治疗5d后2组患者 mMRC、CAT 比较,差异均有统计学意义 (t值分别为2.980、2.267,P 值均<0.05)。结论 口服糖皮质激素对于下叶为主的肺气肿AECOPD患者效果更好。Objective To investigate the effect of oral glucocorticoids in different parts of emphysema.Methods From January to December 2016,80 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)who received oral glucocorticold in Department of Respiratory Medicine Chengdu Second People's Hospital were randomly selected as the hormone group.40 patients with AECOPD who were not given glucocorticoid therapy in the same period were selected as the control group.Changes of modified British medical research council (mMRC)and chronic obstructive pulmonary disease assessment test (CAT)scores before and after glucocorticoid treatment were compared between the two groups.Hormone group patients were divided into upper emphysema group and lower emphysema group according to thoracic High Resolution CT results.Changes in mMRC and CAT scores before and after glucocorticoid treatment were compared between the this two groups.Results There was no significant difference in mMRC,CAT,white blood cell (WBC),and C-reactive protein (CRP)levels between the hormone group and the control group at admission.The difference of mMRC,CAT and CRP between the hormone group and the control group was statistically significant (t =5.681,2.234,3.238, all P <0.05).There was no significant difference in mMRC,CAT,WBC and CRP levels between the upper emphysema group and the lower emphysema group.There was a significant difference in mMRC and CAT between upper emphysema group and lower emphysema group after 5 days of treatment (t = 2.980,2.267,both P <0.05).Conclusions Oral glucocorticoids is better for emphysema in AECOPD patients with predominantly lower lobes.

关 键 词：慢性阻塞性肺疾病 急性加重期 肺气肿 糖皮质激素 改良版英国医学研究会呼吸问卷 慢性阻塞性肺疾病评估测试 

分 类 号：R563.3[医药卫生—呼吸系统] R563.9[医药卫生—内科学]