糖皮质激素对嗜酸性粒细胞增高AECOPD炎症介质的影响  

Effect of glucocorticoid on AECOPD inflammatory mediators in eosinophilia

作　　者：林运团 曾海丽 江荣飞 陈长城 尧国胜[2] LIN Yuntuan;ZENG Haili;JIANG Rongfei;CHEN Changcheng;YAO Guosheng(ICU,Lingyun People＇s Hospital,Lingyun 533199,China;ICU,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,China)

机构地区：[1]广西百色市凌云县人民医院重症医学科,凌云533199 [2]右江民族医学院附属医院重症医学科,百色533000

出　　处：《右江医学》2018年第4期415-418,共4页Chinese Youjiang Medical Journal

摘　　要：目的观察糖皮质激素对嗜酸性粒细胞增高的慢性阻塞性肺疾病(慢阻肺)急性加重期(AECOPD)患者的炎症介质的影响。方法将54例符合AECOPD诊断标准的患者根据外周血嗜酸性粒细胞百分比分成嗜酸性粒细胞增高组(简称增高组)23例及非嗜酸性粒细胞增高组(简称非增高组)31例,两组给予5天醋酸泼尼松龙片30 mg,每日一次口服处理,每组患者于入院第一天及治疗后第7天测定C反应蛋白(CRP)及白介素-8(IL-8)水平。结果治疗后增高组CRP及IL-8水平下降更明显。增高组CRP下降至(5.17±1.83)mg/L,非增高组CRP下降至(11.81±3.99)mg/L,差异有统计学意义(P<0.01);增高组IL-8下降至(8.14±1.13)ng/L,非增高组IL-8下降至(11.87±3.81)ng/L,差异有统计学意义(P<0.01)。结论嗜酸性粒细胞增高的慢阻肺急性加重患者对糖皮质激素治疗更敏感,能更好地减轻全身炎症反应。Objective To observe the effect of glucocorticoid on inflammatory mediators in patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD） with eosinophilia.Methods 54 patients who met the diagnostic criteria of AECOPD were divided into eosinophilia group（ 23 cases） and non eosinophilia group（ 31 cases） according to the percentage of eosinophilic granulocytes in peripheral blood.The two groups were given 30 mg of oral prednisolone acetate tablets once a day for 5 days.C-reactive protein（ CRP） and interleukin-8（ IL-8） levels were measured on the first day of admission and 7 days after treatment in each group.Results The levels of CRP and IL-8 in the eosinophilia group decreased more significantly after treatment.CRP decreased to（ 5.17± 1.83） mg/L in the eosinophilia group,and CRP in the non eosinophilia group decreased to（ 11.81 ± 3. 99） mg/L,difference was statistically significant（ P 0. 01）. IL-8 decreased to（ 8. 14 ± 1. 13）ng/L in the eosinophilia group and to（ 11.87±3.81） ng/L in the non eosinophilia group,difference was statistically significant（ P〈0.01）.Conclusion AECOPD patients with eosinophilia are more sensitive to glucocorticoid therapy,which can reduce systemic inflammatory response better.

关 键 词：慢阻肺急性加重期 糖皮质激素 嗜酸性嗜酸性粒细胞 炎症介质 

分 类 号：R563[医药卫生—呼吸系统]