慢性阻塞性肺疾病频繁急性加重表型患者的临床特征  

Clinical characteristics of patients with frequent acute exacerbation phenotype of chronic obstructive pulmonary disease

作　　者：陈冬冬 叶晓艺[1] 黄颂平[1] CHEN Dongdong;YE Xiaoyi;HUANG Songping(Department of Respiratory and Critical Care Medicine,Quanzhou First Hospital,Fujian Province,Quanzhou 362000,China)

机构地区：[1]福建省泉州市第一医院呼吸与危重症医学科,福建泉州362000

出　　处：《中国当代医药》2025年第2期27-32,共6页China Modern Medicine

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)频繁急性加重表型患者的临床特征。方法回顾性分析2019年1月至2022年12月泉州市第一医院收治的495例因慢性阻塞性肺疾病急性发作(AECOPD)而首次住院患者的临床资料,按照首次住院出院后1年内因AECOPD而住院的次数分为频繁急性加重组(≥2次,181例)与非频繁急性加重组(<2次,314例)。比较两组患者首次住院时的基本情况、肺功能、血气分析和诊治情况。结果频繁急性加重组的嗜酸性粒细胞比率、首次住院前1年AECOPD次数更多的比例均高于非频繁急性加重组,差异有统计学意义(P<0.05)。频繁急性加重组的第1秒用力呼气量(FEV_(1))值低于非频繁急性加重组,差异有统计学意义(P<0.05)。年龄的增加、更高的血嗜酸性粒细胞比率和较低的FEV_(1)与再次入院风险增加相关,差异有统计学意义(P<0.05)。首次住院前1年AECOPD≥2次患者的再入院率高于无AECOPD的患者,差异有统计学意义(P<0.05)。首次住院前使用三联制剂患者的再入院率和再入院风险高于未使用支气管扩张剂的患者,差异有统计学意义(P<0.05)。此外,仍在吸烟患者的再入院率和风险高于从未吸烟患者,差异有统计学意义(P<0.05)。结论嗜酸性粒细胞比例高(≥2%)、FEV_(1)预测值百分比<50%、首次住院前1年AECOPD≥2次的患者更有可能属于COPD频繁急性加重表型。此外,年龄较大、首次住院前接受三联支气管扩张剂治疗、吸烟可能与首次住院后1年内频繁再入院风险独立相关。Objective To investigate the clinical characteristics of patients with frequent acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods The clinical data of 495 patients hospitalized for the first time due to acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in Quanzhou First Hospital from January 2019 to December 2022 were retrospectively analyzed.According to the number of hospitalizations due to AECOPD in the first year after discharge,the patients were divided into frequent acute exacerbation group(≥2 times,181 cases)and non-frequent acute exacerbation group(<2 times,314 cases).The basic condition,lung function,blood gas analysis and diagnosis and treatment of the two groups were compared at the first hospitalization.Results The proportion of eosinophils and the proportion of more AECOPD times in 1 year before the first hospitalization in the frequent acute exacerbation group were higher than those in the non-frequent acute exacerbation group,and the differences were statistically significant(P<0.05).The forced expiratory volume in one second(FEV_(1))in the frequent acute exacerbation group was lower than that in the non-frequent acute exacerbation group,and the difference was statistically significant(P<0.05).Increasing age,higher blood eosinophilic ratio and lower FEV_(1) were significantly associated with an increased risk of readmission,with statistical significance(P<0.05).The readmission rate of patients with AECOPD≥2 times in the 1 year before the first hospitalization was higher than that of patients without AECOPD,and the difference was statistically significant(P<0.05).The readmission rate and readmission risk of patients who used triple agents before the first hospitalization were higher than those who did not use bronchodilators,and the difference was statistically significant(P<0.05).In addition,the readmission rate and risk of patients who were still smoking were higher than those who had never smoked,and the difference was statistically significant(P<0.05)

关 键 词：慢性阻塞性肺疾病 频繁急性加重表型 临床特征 回顾性研究 

分 类 号：R563[医药卫生—呼吸系统]