不同血嗜酸性粒细胞水平的男性COPD患者使用ICS+LABA临床特征观察  

Observation the effect of blood eosinophils and inhaled corticosteroid/long-acting beta-2 agonist in clinical characteristics of COPD

作　　者：香松林[1] 寿志南[1] 唐忠平[1] Xiang Songlin;Shou Zhinan;Tang Zhongping(Department of Respiration,The First People's Hospital of Guiyang,Guiyang 550004,Guizhou,China)

机构地区：[1]贵阳市第一人民医院呼吸内科,贵州贵阳550004

出　　处：《贵州医药》2021年第1期7-9,共3页Guizhou Medical Journal

基　　金：贵阳市卫生计生委科学技术计划项目/高层次创新型青年卫生人才培养计划项目[合同号(2017)筑卫科技合同字第004号];贵州省卫生厅科学技术基金项目(gzwkj2013-1-018)。

摘　　要：目的观察不同血嗜酸性粒细胞水平的男性COPD患者,使用ICS+LABA与否对急性发作次数、住院次数、肺炎累患次数、FEV1、mMRC等的影响。方法随机选择142例男性稳定期COPD患者,以血EOS≥2%及是否使用ICS+LBAB将其分为A组(EOS≥2%,使用ICS+LBAB治疗)、B组(EOS≥2%,使用除ICS+LBAB以外的治疗方案)、C组(EOS<2%,使用ICS+LBAB治疗)、D组(EOS<2%,使用除ICS+LBAB以外的治疗方案);随访1年,记录并比较四组治疗前后mMRC评分、FEV1%Pred、FEV1,1年内急性加重次数、住院治疗次数、肺炎累患次数。结果随访1年,完成本研究共112例,以GOLD 2~3级COPD患者为主,各组间年龄、BMI无统计学差异(P>0.05)。随访1年后,A组FEV1下降较B组少(P=0.002),B、D组FEV1下降差异无统计学意义(P>0.05);B组急性加重率高于A、C、D组(P<0.05);余各组间无统计学意义(P>0.05);住院率B组较D组高(P=0.01),余各组间无统计学差异(P>0.05);肺炎累患率各组间比较无统计学差异(P>0.05)。治疗前各组mMRC评分有统计学差异(P=0.026),治疗后mMRC评分各组间无统计学差异(P>0.05)。结论对血EOS≥2%的COPD患者,使用含ICS+LABA方案治疗可延缓FEV1下降,降低年急性加重率及住院率,未见肺炎累患率增加,药物干预在缓解患者自主呼吸困难程度方面起到一定作用。Objective To observe the effect of blood eosinophils(EOS)and inhaled corticosteroid/long-acting beta-2 agonist efficacy in acute episodes,hospitalizations,pneumonia,and force expiratory volume in 1 second(FEV1)and modified British medical research council(mMRC)in COPD.Methods 142 male stable COPD patients were randomly selected.They were divided into A group(EOS≥2%,treatment with an inhaled corticosteroid(ICS)/long-actingβ2 agonist(LABA)),B group(EOS≥2%,and treatment without ICS+LBAB),C group(EOS<2%,treatment with an ICS+LBAB),D group(EOS<2%,treatment without ICS+LBAB).Follow up for 1 year,record and compare the four groups before and after treatment mMRC score,FEV1%Pred,FEV1,the number of acute aggravation,hospitalizations,Number of cases of pneumonia.Results After 1 year follow-up,112 cases were completed,mainly GOLD2~3 COPD patients,and there were no statistical significantly differences between the groups in age and BMI(P>0.05).But the decline of FEV1 in Group A was significantly slower than B(P=0.002),there were no statistical significantly differences in Groups B and D(P>0.05).Compared with groups one by one,the annual acute aggravation rate of Group B was highest than other Groups(P<0.05).There were no statistical significantly differences between the remaining groups comparison(P>0.05).Hospitalization rate of group B was higher than group D(P=0.01),and there were no statistical significantly differences between the remaining groups(P>0.05).There were no statistical significantly differences in the annual rate of pneumonia(P>0.05).There were statistical significantly differences among the groups in mMRC score-before(P=0.026),mMRC score-after and there were no statistical significantly differences between the groups(P>0.05).Conclusion For patients with blood EOS≥2%COPD,using of ICS+LABA treatment can delay the decline of FEV1,reduce the annual acute aggravation rate and hospitalization rate,and do not increase the rate of pneumonia recurrence,drug intervention in patients with spontaneous breathing d

关 键 词：慢阻肺 嗜酸性粒细胞 一秒量 吸入糖皮质激素 

分 类 号：R714.253[医药卫生—妇产科学]