特应性与慢性阻塞性肺疾病症状、急性加重的相关性研究  

A study on the correlation between atopy and symptoms,exacerbation of patients with chronic obstructive pulmonary disease

作　　者：周雨燕 陈潇婷 王宛莹 李静[1] 李德帅 卜小宁[1] Zhou Yuyan;Chen Xiaoting;Wang Wanying;Li Jing;li Deshuai;Bu Xiaoning(Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China;Department of Respiratory and Critical Care Medicine, Beijing Renhe Hospital, Beijing 100029, China)

机构地区：[1]首都医科大学附属北京朝阳医院呼吸与危重症医学科北京市呼吸疾病研究所,北京100020 [2]北京仁和医院呼吸与危重症医学科,北京102699

出　　处：《首都医科大学学报》2022年第4期635-640,共6页Journal of Capital Medical University

基　　金：北京市首都卫生发展科研专项(2018-2-1062)。

摘　　要：目的探讨特应性与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD,以下简称慢阻肺)的呼吸道症状与急性加重的相关性。方法前瞻性、观察性队列研究,收集2018年1月至2019年6月就诊于首都医科大学附属北京朝阳医院的稳定期慢阻肺患者共178例,根据血清吸入过敏原过筛试验阳性,将患者分为特应性组(27例)和非特应性组(151例)。收集患者人口学资料、临床症状、实验室检查等并随访12个月,记录慢阻肺急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)情况。结果经倾向性评分匹配后,特应性组(n=27)较非特应性组(n=77)喘息症状方面增多(77.78%vs 55.84%),差异具有统计学意义(P=0.044)。特应性组血清总免疫球蛋白E(immunoglobulin E,IgE)浓度显著高于非特应性组,肺功能中第1秒用力呼气容积(forced expiratory volume in first second,FEV1)实测值也显著高于非特应性组,差异具有统计学意义(P<0.001,P=0.019)。随访1年,特应性组频繁重度急性加重次数较非特应性组显著增加(29.63%vs 10.39%),差异具有统计学意义(P=0.038)。结论特应性可以导致慢阻肺患者喘息症状增多,频繁重度急性加重次数增多。Objective To investigate the correlation between atopy and respiratory symptoms,acute exacerbation of patients with chronic obstructive pulmonary disease(COPD).Methods There were 178 patients with stable chronic obstructive pulmonary disease from Beijing Chaoyang Hospital,Capital Medical University from January 2018 to June 2019 were collected.According to the positive serum inhalation allergen screening test,the patients were divided into atopic group(27 cases)and non-atopic group(151 cases).The demographic data,clinical symptoms and laboratory examinations of patients were collected and followed up for 12 months.The acute exacerbation of chronic obstructive pulmonary disease(AECOPD)was recorded.Results After propensity score matching,the symptoms of wheezing in the atopic group(n=27)were higher than those in the non-atopic group(n=77)(77.78%vs 55.84%).The difference was statistically significant(P=0.044).The total serum immunoglobulin(IgE)level in the atopic group was significantly higher than that in the non-atopic group,and the value of forced expiratory volume in first second(FEV1)was also significantly higher than that in the non-atopic group(P<0.001,P=0.019).Following up for 12 months,the frequency of frequent severe acute exacerbations in the atopic group was significantly higher than that in the non-atopic group(29.63%vs 10.39%),and the difference was statistically significant(P=0.038).Conclusions Atopy can lead to the increase of wheezing symptoms,severe and frequent acute exacerbations in patients with COPD.

关 键 词：慢性阻塞性肺疾病(COPD) 特应性 症状 急性加重 

分 类 号：R563[医药卫生—呼吸系统]