慢性阻塞性肺疾病急性加重住院患者调整长效支气管扩张剂为短效支气管扩张剂治疗对发生心律失常风险的临床分析  被引量:5

Clinical analysis of the risk of arrhythmia in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease when switching from long-acting bronchodilators to short-acting bronchodilators

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作  者:娜合木古丽·阿依达尔汗 张强[2] 韩武新 金洪[1] 恩卡尔·波拉提 曾晓凤 Nahemuguli Ayidaerhan;Zhang Qiang;Han Wuxin;Jin Hong;Enkar Bolati;Zeng Xiaofeng(Department of Respiratory and Critical Care Medicine and Laboratory of the People′s Hospital of Tacheng Area,Xinjiang 834300,China;Second Respiratory Department,Shengjing Hospital of China Medical University,Shenyang110022,China)

机构地区:[1]新疆塔城地区人民医院呼吸与危重医学科,检验科,新疆塔城834300 [2]中国医科大学附属盛京医院第二呼吸内科,辽宁沈阳110022

出  处:《实用药物与临床》2022年第11期985-990,共6页Practical Pharmacy and Clinical Remedies

基  金:2020年新疆维吾尔自治区创新环境(人才、基地)建设专项(自然科学基金)资助项目(2020D01A123)。

摘  要:目的了解慢性阻塞性肺疾病急性加重(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者住院期间将长效β_(2)受体激动剂(Long-actingβ_(2)-agonist,LABA)和长效抗胆碱能药物(Long-acting muscarinic antagonist,LAMA)调整为短效β_(2)受体激动剂(Short-actingβ_(2)-agonist,SABA)和短效抗胆碱能药物(Short-acting muscarinic antagonist,SAMA)治疗与继续原吸入治疗相比,患者的临床特点及新发心律失常的发生率,并探讨新发心律失常的危险因素。方法回顾性选取新疆塔城地区人民医院呼吸科2020年1月-2021年12月诊治的207例确诊AECOPD的患者,根据住院后是否调整为SABA/SAMA将患者分为2组,SABA/SAMA组共157例,LABA/LAMA组50例,比较两组患者的基本临床特征、肺功能、心脏相关合并症、居家治疗用药、入院时氧合指数、吸氧浓度、心率、死亡率、住院日以及在院期间心律失常的发生率。再以是否发生心律失常分组,探讨相关调查指标间的统计学差异,并对其中有意义的变量进行二元Logistic回归,探讨影响新发心律失常的因素。结果SABA/SAMA组和LABA/LAMA组患者的年龄、性别、吸烟、肺功能、心脏合并症,居家治疗中控制心律药物、应用支气管扩张剂、心律失常发生率以及住院日和死亡率的差异均无统计学意义(P>0.05)。但SABA/SAMA组较LABA/LAMA组有更低的氧合指数(P=0.016)、更高的心率(P=0.017),所需吸氧浓度更高(P=0.023)。发生心律失常组(193例)较无心律失常组(14例)有更多患者有阵发性房颤病史(P=0.006),入院时心率较高(P=0.038),吸氧浓度较高(P=0.020),两组间其他指标间的差异均无统计学意义。二元Logistic回归分析表明,既往阵发性房颤史是住院期间出现新发心律失常的独立危险因素(OR=0.180,95%CI:0.054~0.601,P=0.005)。结论在需要住院的AECOPD患者中,将LABA/LAMA调整为SABA/SAMA可能不会增加心律失常的风险,但阵发性房颤史是住院�Objective To learn about the clinical characteristics and the incidence of new-onset arrhythmias in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)whose treatments were switched from long-acting β_(2)-agonist/long-acting muscarinic antagonist(LABA/LAMA)to short-acting β_(2)-agonist/short-acting muscarinic antagonist(SABA/SAMA)during hospitalization compared with those continuing the original inhalation therapy,and to explore the risk factors of new-onset arrhythmias.Methods A total of 207 patients who were diagnosed with AECOPD in the Department of Respiratory Medicine of the People′s Hospital of Tacheng,from January 2020 to December 2021 were retrospectively selected,and the patients were divided into two groups according to whether they were adjusted to SABA/SAMA after hospitalization.SABA/SAMA group(157 cases)and LABA/LAMA group(50 cases)were compared in terms of basic clinical characteristics,pulmonary function,heart-related complications,home treatment medication,oxygenation index on admission,oxygen inhalation concentration,heart rate,death rate,days of hospital stay,and incidence of arrhythmias during hospitalization.Then,the patients were divided into groups according to the occurrence of arrhythmia,the statistical differences among the relevant survey indicators were discussed,and binary Logistic regression was performed on the significant variables to explore the factors affecting the new-onset arrhythmia.Results There was no significant difference in age,gender,smoking,lung function,cardiac comorbidities,rhythm control drugs treatment at home,bronchodilator use,incidence of arrhythmia,days of hospital stay and mortality in hospital between SABA/SAMA group and LABA/LAMA group(P>0.05).However,the SABA/SAMA group had lower oxygenation index(P=0.016),higher heart rate(P=0.017),and higher oxygen concentration(P=0.023)than the LABA/LAMA group.Compared with the non-arrhythmic group(14 cases),more patients in the arrhythmia group(193 cases)had a history of paroxysmal atria

关 键 词:慢性阻塞性肺疾病急性加重 支气管扩张剂 短效β2受体激动剂/短效抗胆碱能药物 心律失常 长效β2受体激动剂/长效抗胆碱能药物 

分 类 号:R563.9[医药卫生—呼吸系统]

 

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