吸入性糖皮质激素增加哮喘患者肺炎风险

Influence of inhaled corticosteroids on community-acquired pneumonia in patients with bronchial asthma

目的探讨哮喘患者长期吸入激素(ICS)是否增加肺炎发生风险。方法选择上海市杨浦区市东医院07年1月～07年12月哮喘患者共300例,其中使用ICS者156例(A组),未使用者144例(B组),并选择同期健康志愿者150例(C组)。结果随访6、12、18、24个月结束时,A组患者ICS使用总量分别为28.50 g、50.10 g、61.30 g、69.10 g,发生肺炎分别为10、23、37、53例次;B组发生肺炎分别为7、14、22、29例次;C组发生肺炎分别为9、16、26、33例次。B组和C组比较差异无统计学意义(P>0.05)。A组和B组、C组比较差异有统计学意义(P<0.05)。结论长期使用ICS增加肺炎风险,随着剂量和时间增加,肺炎发病机会增高,但预后良好。

Objective To determine wheather the use of ICS in asthma patients increased the risk of pneumonia. Methods 300 patients with asthma in Shidong hospitals from Jan. 2007 to Dec. 2007 were observed. There were 156 cases who used ICS in Group A, 144 cases without [CS in Group B, and 150 cases of normal control people as the Group C. In the 2 years following-up, the dosages of 1CS and incidence of pneumonia were recorded. R^ults The dosages of ICS in Group A after 6 months, 12 months, 18 months,24 months were 28.50 g,50. 10 g, 61.30 g, and 69. 10 g, respectively. The occurrence times of pneumonia in Group A were 10 cases, 25 cases, 37 cases and 53 cases, respectively, while in Group B were 7 cases, 14cases, 22 cases and 29 cases and in Group C were 9 cases, 16 cases, 26 cases and 33 cases. Compared between group B and C, there was no significant difference （ P 〉 0. 05 ）. Compared between group A and B, and Group A and C, there were significant differences （ P 〈 0. 05 ）. Conclusion Long time use of ICS can increase the risk of pneu- monia, and the incidence increases with the dosage and time of use of ICS, while the prognosis is well.