真实世界中痰嗜酸性粒细胞阳性慢阻肺对吸入激素治疗的疗效观察

Observation on the efficacy of inhaled corticosteroids in the treatment of sputum eosinophils positive chronic obstructive pulmonary disease in the real world

目的:观察真实世界中痰嗜酸性粒细胞阳性的慢性阻塞性肺疾病(简称慢阻肺)患者使用吸入激素与痰嗜酸性粒细胞(Eos)、FENO、FEV1/FVC、CAT评分的关系。方法:收治初次发病的慢阻肺痰嗜酸性粒细胞阳性患者104例;分别检测痰嗜酸性粒细胞、FENO、FEV1/FVC,CAT评分和用药情况。分A组(规律使用ICS患者)、B组(未使用ICS或使用ICS累计时间少于1个月,规律使用其他药物),分析两组痰嗜酸性粒细胞水平与FENO、FEV1/FVC、CAT评分关系。结果:A组痰嗜酸性粒细胞转阴32例(80.0%)高于B组的18例(56.2%)(P<0.05)。A组和B组稳定期的FENO较急性期均降低,差异有统计学意义(P<0.05),且FENO与嗜酸性粒细胞水平呈正相关(P<0.01);CAT评分第2次较第1次均有改善(P<0.05),A组改善更明显(P<0.05)。结论:长期使用ICS可能改善痰嗜酸性粒细胞阳性慢阻肺患者的生活质量,FENO可以作为预测慢阻肺痰嗜酸性粒细胞炎症反应程度的指标。

Objective:To observe the relationship between the use of inhaled hormones and sputum eosinophils(Eos),FENO,FEV1/ FVC,CAT scores in patients with chronic obstructive pulmonary disease(COPD)with positive sputum eosinophils in the real world. Methods:104 patients with phlegm eosinophils in the first episode of chronic obstructive pulmonary disease were selected,we detected sputum eosinophils,FENO,FEV1/FVC,CAT score and medication use situation.They were divided into the group A(patients who regularly used ICS),the group B(patients who did not use ICS or used ICS for less than one month and regularly used other drugs),the relationship between sputum eosinophil level and FENO,FEV1/FVC and CAT scores in the two groups were analyzed.Results:In the group A,32 cases(80%)of sputum eosinophils turned negative,higher than 18 cases(56.2%)in the group B(P<0.05),and FENO was positively correlated with eosinophil level(P<0.01).CAT score was improved the second time than the first time(P<0.05),the group A improved more obviously(P<0.05).Conclusion:Long term use of ICS may improve the quality of life in patients with sputum eosinophil positive COPD,FENO can be used as an indicator for predicting the degree of phlegm eosinophil inflammation in COPD.