摘要
目的了解慢性气流受限性疾病的临床特征,评估其病情及预后。方法对2014年9月1日至2015年10月31日在北京市第六医院门急诊及住院就诊的明确有慢性气道疾病的119例患者进行问卷调查及完善检查;根据2014年全球哮喘防治创议(GINA)的临床综合评估标准筛选出哮喘、慢性阻塞性肺疾病(COPD)及哮喘-慢性阻塞性肺疾病重叠综合征(ACOS)患者,对比3组患者的临床特征、随诊CAT评分、ACT评分、肺功能、急性发作次数、住院次数及医疗花费。结果 ACOS组CAT评分、PO2、PCO2及乳酸水平与COPD组差异无显著性(P>0.05),ACT评分PO2低于哮喘组(P>0.05);ACOS组外周血嗜酸细胞高于COPD组(P<0.05),与哮喘组差异无显著性(P>0.05)。ACOS组C-反应蛋白(CRP)高于哮喘(P<0.05),与COPD组差异无显著性(P>0.05)。ACOS组FEV_1占预计值百分比(FEV_1%)明显低于哮喘组(P<0.05),与COPD组差异无显著性(P>0.05)。经过系统治疗后ACOS组FEV_1改善量及FEV_1改善率均高于COPD组(P<0.05)。ACOS组可逆试验后FEV_1的改善量及改善率与COPD组差异无显著性。ACOS组可逆试验后FEV_1改善量低于哮喘组(P<0.05),可逆试验后FEV_1改善率及系统治疗后FEV_1改善量及改善率与哮喘组比较均差异无显著性(P>0.05)。ACOS组年急性发作次数、年住院次数、平均住院日及年医疗花费均略高于COPD组,差异无显著性(P>0.05),明显高于哮喘组(P<0.05)。结论 ACOS与哮喘具有相似的气道变应性及变异性,与COPD具有相似临床症状、炎性反应、氧合及气流受限程度,疾病风险高、医疗耗费大,预后差。
Objective To understand the clinical characteristics of chronic airflow restricted diseases and evaluate its condition and prognosis. Method Questionnaire survey and related examinations were done to 119 patients of chronic airflow restricted diseases. Asthma, chronic obstructive pulmonary disease （COPD）, and asthma-chronic obstructive pulmonary disease overlapping syndrome （ACOS） patients were screened according to the clinical comprehensive evaluation standard screen of Global initiative for asthma （GINA） in 2014. The clinical features, follow-up CAT score, ACT score lung fimction, the number of acute attacks and hospitalization, the cost of medical treatment were compared among the three groups. Result There were no significant difference in the follow-up CAT score, PO2, PCO2, lactic acid, C reactive protein and FEV1% between Group ACOS and COPD（P〉0.05）, while peripheral eosinophil was significantly higher in Group ACOS than that in Group COPD（P〈0.05）. ACT score PO2 and FEV1% in the Group ACOS were significantly lower than that in the Group Asthma （P〈0.05）, while C reactive protein was signifycantly higher in Group ACOS than that in Group Asthma（P〈0.05）. There was no significant difference in peripheral eosinophil between Group ACOS and Asthma（P〉0.05）. After systematic treatment： the improvement and improvement rate of FEV~ was significantly higher in Group ACOS than that in Group COPD（P〈0.05）, and there were no significant difference in improvement and improvement rate of FEVx after reversible test between these two groups（P〉0.05）. The improvement of FEV1 after reversible test in Group ACOS was significantly lower than that in Group Asthma（P〈0.05）, and there were no significant difference in improvement rate and improvement and improvement rate of FEVt after reversible test between these two groups（P〉0.05）. The number of an annual acute attacks and annual hospitalization, average length of stay and annual medical cost were significantly higher in Group ACOS than that in Group Asthma（P〈0.05）, but not significantly higher than that in Group COPD （P〉0.05）. Conclusion ACOS with high risk, high cost of medical treatment and poor prognosis has similar airway allergy and variabilly as asthma and similar clinical symptoms, inflammatory reactions, oxygenation and airflow limitation as COPD.
作者
魏丽娟
郑平
庄蝶微
郭丽
崔娜
WEI Li-juan1, ZHENG Ping2, ZHUANG Die-wei1, GUO Li1, CUI Na1(1. Department of Respiratory Medicine, Beijing No.6 hospital Beijing 100007, China; 2. Clinical Department of Strategic Support Force Aerospace Systems in Beijing Space City, Beijing 100094, Chin)
出处
《中国医刊》
CAS
2018年第3期281-284,共4页
Chinese Journal of Medicine
基金
北京市东城区科技计划项目(2015-5-006)
关键词
慢性阻塞性肺疾病
支气管哮喘
哮喘-慢性阻塞性肺疾病重叠综合征
临床特征
Chronic obstructive pulmonary
Bronchial asthma
Asthma-chronic obstructive pulmonary disease overlapping syndrome
Clinical features
