糖皮质激素对嗜酸性粒细胞阳性AECOPD患者临床疗效观察  

Clinical effect of glucocorticoids on eosinophilic positive patients with AECOPD

作　　者：林运团 曾海丽 江荣飞 陈长城 尧国胜[2] LIN Yun-tuan;ZENG Hai-li;JIANG Rong-fei(Department of Critical Care Medicine,the People's Hospital of Lingyun County,Guangxi 533199,China)

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

出　　处：《中国临床新医学》2019年第6期665-668,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的观察糖皮质激素对嗜酸性粒细胞阳性的慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效。方法将60例符合AECOPD诊断的患者,根据外周血嗜酸性粒细胞百分比分成嗜酸性粒细胞阳性组(≥2%)33例,嗜酸性粒细胞阴性组(<2%)27例。两组在常规治疗基础上第1~5天给予注射用甲泼尼龙琥珀酸钠40mg,1次/d。于入院第1天及第7天测定C反应蛋白(CRP)及白细胞介素-8(IL-8),并于入院后第7天评估临床疗效。结果嗜酸性粒细胞阳性组CRP及IL-8水平下降较嗜酸性粒细胞阴性组更明显。嗜酸性粒细胞阳性组治愈21例,好转10例,无效2例;嗜酸性粒细胞阴性组分别为12例、6例和9例。嗜酸性粒细胞阳性组临床疗效优于嗜酸性粒细胞阴性组(P<0.05)。结论嗜酸性粒细胞阳性组对糖皮质激素反应效果较阴性组好,在临床中可以考虑对嗜酸性粒细胞阳性AECOPD患者使用糖皮质激素。Objective To observe the clinical effect of glucocorticoids on eosinophilic positive patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Sixty AECOPD patients were divided into eosinophilic positive group(n=33)and eosinophilic negative group(n=27)according to the percentage of eosinophils in peripheral blood,and the two groups were given methylprednisolone 40 mg daily for 5 days.The levels of C-reactive protein(CRP)and interleukin-8(IL-8)were detected on the first day and the seventh day of admission.The clinical efficacy was evaluated on the seventh day of admission.Results The levels of CRP and IL-8 in the eosinophilic positive group were decreased significantly compared with those in the eosinophilic negative group.In the eosinophilic positive group,21 cases were cured,10 cases improved,and 2 cases ineffective.In the eosinophilic negative group,12 cases were cured,6 cases improved,and 9 cases ineffective.The eosinophilic positive group had better clinical efficacy than the eosinophilic negative group(P<0.05).Conclusion Glucocorticoids have a better clinical effect on the eosinophilic positive patients with AECOPD than the with eosinophilic negative patients with AECOPD.

关 键 词：慢性阻塞性肺疾病急性加重期 糖皮质激素 嗜酸性粒细胞 

分 类 号：R563[医药卫生—呼吸系统]