吸入用糖皮质激素对外周血嗜酸性粒细胞增多AECOPD患者肺功能的影响

Effects of inhaled corticosteroids on the pulmonary function of AECOPD patients with increasing peripheral blood eosinophil

目的观察吸入用糖皮质激素(ICS)对外周血嗜酸性粒细胞增多慢性阻塞性肺疾病急性加重(AECOPD)患者肺功能的影响。方法267例慢性阻塞性肺疾病患者,按照入院时外周血EOS分为嗜酸组(EOS≥100个/μL)和非嗜酸组(EOS<100个/μL),根据患者出院时维持药物中是否含有ICS分为含ICS组和不含ICS组,嗜酸组患者又分为含ICS和不含ICS组;记录患者性别、年龄、体质量指数(BMI)、吸烟、糖尿病、高血压、入院前1年急性加重风险以及维持治疗方案,采用Pearson分析EOS水平与肺功能相关性。结果嗜酸组与非嗜酸组、含ICS组与不含ICS组患者性别、年龄、BMI、吸烟、糖尿病、高血压、入院前1年急性加重风险以及维持治疗方案等方面比较,差异无统计学意义(P>0.05);而CRP、EOS、FEV 1、FEV1/FVC、PEF以及出院后1年内中重度加重等方面比较,差异具有统计学意义(P<0.05);Pearson相关性分析结果显示,EOS水平与FEV1、FEV1/FVC以及PEF呈负相关(r=-0.562、-0.644、-0.778,P<0.001)。结论EOS≥100个/μL的慢性阻塞性肺疾病患者加用ICS维持治疗可降低急性加重风险,改善患者肺功能。

Objective To observe the effect of inhaled corticosteroids(ICS)on the pulmonary function of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with increasing peripheral blood eosinophil(EOS).Methods Two hundred and sixty-seven patients with chronic obstructive pulmonary disease were divided into EOS group(EOS≥100/μL)and non-EOS group(EOS<100/μL)according to peripheral blood EOS;patients with ICS were divided into ICS-containing group and ICS-free group,and the EOS group was divided into ICS-containing and ICS-free subgroups;patients'gender,age,body mass index(BMI),smoking,diabetes,hypertension,the risk of the acute exacerbation and the maintenance treatment plan 1 year before admission were recorded.Pearson was adopted to analyze the correlation between EOS level and lung function.Results There were no significant differences in gender,age,BMI,smoking,diabetes,hypertension,the risk of acute exacerbation,and the maintenance treatment plan 1 year before admission between the eosinophilic group and the non-eosinophilic group,and between the ICS group and the ICS-free group(P>0.05);there were statistically significant differences in CRP,EOS,FEV1,FEV1/FVC,PEF,and moderate to severe exacerbation within 1 year after discharge(P<0.05);Pearson correlation analysis showed that there was negative correlation between EOS levels with FEV1,FEV1/FVC and PEF(r=-0.562,-0.644,-0.778;P<0.001).Conclusion The addition of ICS to maintenance therapy for patients with chronic obstructive pulmonary disease with EOS≥100/μL can reduce the risk of acute exacerbation and improve the lung function of patients.