支气管哮喘患者血浆皮质醇水平及相关因素回顾分析

Retrospective analysis of plasma cortisol level and relative factors for patients with asthma

目的探讨支气管哮喘（简称哮喘）患者血浆皮质醇水平与哮喘患者病情、肺功能、既往治疗等相关因素的关系。方法统计哮喘患者的血浆皮质醇水平、基本情况、血常规、肺功能、住院情况、既往治疗状况、吸烟状况、体质量指数、骨密度检测结果，按皮质醇状况分为低组、正常组和高组，进行对照分析。结果①患者基本状况：性别：男／女为1：1．2，皮质醇增高组的患者中男性明显大于女性，男／女为1：0．46，与其他两组相比差异具有统计学意义；年龄：皮质醇低于正常的患者年龄偏大，病程长，与其他两组相比差异具有统计学意义。②三组患者的住院次数：皮质醇降低组最高，为65．27％，皮质醇增高组最低，为10．3％。三组之间比较差异具有统计学意义（P〈0．01）。③患者嗜酸粒细胞比例和绝对值三组均高于正常值，但皮质醇低组低于其余两组，差异具有统计学意义（P〈0．05）；而皮质醇正常组与高组比较，差异无统计学意义（P〉0．05）。④肺功能检测指标：皮质醇低组最低，皮质醇高组最高。=三组比较差异具有统计学意义（P〈0．01）。⑤共有299例皮质醇减低的住院患者进行了骨密度检测，骨量异常者占67．9％。⑥件院患者既往治疗状况显示：用过全身激素和非正规来源药物者在皮质醇低组数量最多，与其余两组比较差异具有统计学意义；皮质醇低组用吸入激素的患耆数量最少，与其余两组比较差异具有统计学意义。结论哮喘患者皮质醇的高低，与患者的性别、年龄、住院次数、肺功能指标、使用全身激素等因素有相关性，检测皮质醇对于判断患者病情、治疗反应、药物安全性等具有明确意义。

Objective To explore the relationships between plasma cortisol level of patients with asthma and relative factors, such as patient＇s condition, pulmonary function and previous treatment. Methods Collected the results of plasma cortisol level, basic situation, blood test, pulmonary function. hospitalization, prior treatment status,bone mineral density test and so on of all the patients that received the cortisol test,and also that of the indexes of smoking and body mass of inpatients that received the cortisol test. All the patients were divided into low group,normal group and high group according to the cortisol status,and made comparison analysis between the three groups. Results （1）The basic situation： the total male female ratio is 1 ： 1.2; the ratio of men is obviously higher than that of momen in high group,and the male female ratio is 1 ： 0.46.which is statistically different compared to the other two groups;judging from the age,that of the low group tended to be older,and the course of disease of which is longer, besides,it is statistically different compared to the other two groups. （2）Judging from the ratio of hospitalization, the low group is the highest of the three, the ratio of which is 65.27%, while the high group is the lowest, with a ratio 10.3 %,and there were significant difference among the three groups, P 〈0.01.The proportion and absolute value of eosinophil of the three groups were higher than normal, and that of the low group was lower than the other two groups, with statistical significance, P 〈0.05there was no statistical significance between the normal group and high group, P 〉0. 05. （4）Judging from pulmonary function,that of the low group is the lowest among the there group,and the high group is the highest, P 〈0.01,and there were significant difference among the three groups. P 〈0.01. @299 inpatients with low cortisol level received bone mineral density test,and patients with normal bone mineral density accounted for 32.1 % ,while patients with abnormal bone mineral density accounted for 67.9%. （6）Prior treatment status of the hospitalized patients： the number of the patients received systemic steroid, non-formal sources of drugs and other treatments in the low group were more than the other two groups, with a statistically significant difference compared with the other two groups;and that of patients used inhaled corticosteroid in the low group was lowest, and there was statistically significant among groups. Conclusions Plasma cortisol level can reflect lots of aspects of the patients with asthma, which made great sense in judging the condition of the patients, response to treatment,drug safety and so on.