慢性阻塞性肺疾病急性加重患者的临床特征分析

Analysis of clinical features of acute exacerbated chronic obstructive pulmonary disease patients

目的分析慢性支气管炎(以下简称:慢支炎)与肺气肿表型慢性阻塞性肺疾病(COPD)急性加重(AECOPD)患者的临床特征。方法选取2014年1月至2016年11月于四川大学华西医院西藏成办分院就诊的慢支炎表型AECOPD患者73例、肺气肿表型AECOPD患者82例,所有患者均完善肺功能检查、基础信息采集、呼吸困难量表评分(MMRC)、COPD评估测试(CAT),收集患者血清进行C反应蛋白(CRP)检测,比较其临床特征、肺功能、并发症、系统性炎症等指标差异。结果慢支炎表型与肺气肿表型AECOPD患者在体质量指数(BMI)、CAT评分、血清CRP水平、平均住院时间等方面比较,差异无统计学意义(P>0.05)。与慢支炎表型COPD患者相比,肺气肿表型COPD患者吸烟史更长,呼吸困难更加明显,肺功能受损程度更加严重(P<0.05)。结论不同表型的AECOPD患者具有不同的临床特征,肺气肿表型AECOPD患者呼吸困难、肺功能受损程度较慢支炎表型更加明显。

Objective To compare clinical characteristics between acute exacerbated chronic obstructive pulmonary disease（AECOPD）patients with chronic bronchitis phenotype and emphysema phenotype.Methods A total of 73 AECOPD patients with chronic bronchitis phenotype and 82 AECOPD patients with emphysema phenotype in Tibet Chengdu Branch Hospital,West China Hospital,Sichuan University from January2014 to November 2016 were selected.All patients had completed lung function tests,basic information collection,modified medical research council dyspnea scale（MMRC）,and COPD assessment test（CAT）.The serum samples were collected to detect C-reactive protein（CRP）.The clinical characteristics,lung function,complications and systemic inflammation between the two groups were compared.Results There was no difference in body mass index（BMI）,CAT score,serum CRP level and length of hospital stay between the AECOPD patients with chronic bronchitis phenotype and emphysema phenotype（P〉0.05）.Compared with AECOPD patients with chronic bronchitis phenotype,the AECOPD patients with emphysema phenotype have longer smoking history,higher MMRC score,and more severe lung function impairment（P〈0.05）.Conclusion AECOPD patients with chronic bronchitis phenotype and emphysema phenotype have different clinical characteristics,those with emphysema phenotype have more severe dyspnea and lung function impairment.