哮喘急性发作患者肺功能恢复时间的影响因素分析

Analysis of Influencing Factors of Lung Function Recovery Time in Patients with Acute Asthma Exacerbations

目的分析严重哮喘急性发作给予适当治疗后,引起肺功能恢复时间延长的相关因素。方法回顾性分析2013年12月—2016年7月新疆医科大学第一附属医院急诊科收治的51例哮喘急性发作患者。收集患者入院前及入院时有关临床指标,并运用统计学软件对数据进行分析。结果共有51例符合入组标准,男25例;平均年龄(52.2±18.9)岁;其中肥胖患者(BMI>30 kg/m2)28例;既往有哮喘的患者27例;哮喘急性发作前规律使用糖皮质激素15例;伴有心脏病7例,伴有糖尿病12例,伴有过敏性鼻炎患者28例;入院后,需给予吸氧治疗29例,并发肺炎20例,并发呼吸道病毒感染18例;患者出院时肺功能优于入院时,差异有统计学意义(P<0.001);51例患者的肺功能恢复时间范围较宽,为1~12 d,平均恢复时间(6.6±2.5)d;单因素分析显示哮喘急性发作前规律使用糖皮质激素(P<0.001),入院期间并发呼吸道病毒性感染(P<0.001),过敏性鼻炎(P=0.009)会导致肺功能恢复时间延长;多因素COX比例风险回归分析结果显示哮喘急性发作前规律使用糖皮质激素、入院时并发呼吸道病毒性感染与肺功能恢复时间延长具有相关性(P<0.05)。结论哮喘急性发作后肺功能恢复的时间在不同患者之间是不同的,长期使用糖皮质激素以及并发呼吸道病毒感染是影响恢复时间的重要因素。

Objective To analyze the related factors of prolonged recovery of lung function after acute treatment of severe asthma. Methods Retrospective analysis 51 cases with Acute Asthma Exacerbations in First Affiliated Hospital of Xinjiang Medical University from December 2013 to July 2016. Clinical data were collected before and after hospitalization and analyzed using statistical software. Results A total of 51 patients met the inclusion criteria,25 males, mean age（ 52. 2 ±18. 9） years,including 25 cases of obese patients（ BMI 〉 30 kg/m2）,27 cases of previous asthma patients,15 cases using regular glucocorticoid before an acute asthma exacerbation,7 cases with heart disease,12 cases with diabetes,28 patients with allergic rhinitis and after admission,29 cases need oxygen therapy,20 cases complicated with concurrent pneumonia,18 cases complicated with respiratory virus infection. Patients had significantly better pulmonary function when discharged from hospital（ P〈 0. 001）. The recovery time of lung function in 51 patients was 1-12 d, the average recovery time was（ 6. 6 ± 2. 5）d. Univariate analysis showed that glucocorticoids were used before an acute asthma exacerbation（ P 〈 0. 001）,respiratory tract infection（ P 〈 0. 001） and allergic rhinitis（ P = 0. 009） during admission resulted in prolonged lung function recovery. Multivariate COX proportional risk regression analysis showed that using regular glucocorticoids before an acute asthma exacerbation and complicated with respiratory virus infection were associated with prolonged recovery of lung function（ P 〈0. 05）. Conclusion The time of recovery of lung function between different patients after acute asthma exacerbations is different. Long-term use of glucocorticoids and complicated with respiratory virus infection is an important factor affecting lung function recovery time.