Chang Chun, Yao Wanzhen
Department of Respiratory Medicine, Peking University Third Hospital, Beijing, China (mainland).
Med Sci Monit. 2014 Feb 25;20:311-20. doi: 10.12659/MSM.889828.
When exacerbation of chronic obstructive pulmonary disease (AECOPD) occurs frequently, patients have high levels of airway and systemic inflammation and a poor quality of life. This study compared the nature and course of systemic and airway inflammation during AECOPD between patients who experienced frequent exacerbations and those with non-frequent exacerbations.
Consecutive hospitalized patients with AECOPD were recruited and divided into 2 groups according to the frequency of AECOPD they had experienced in the previous year. Frequent exacerbators (defined as 2 or more AECOPD in the previous year) and non-frequent exacerbators (defined as zero or 1 AECOPD in the previous year). Inflammatory (interleukin 6, interleukin 8, myeloperoxidase, and C-reactive protein) and clinical (dyspnea, COPD assessment test (CAT), and peak expiratory flow) indices were assessed on the day of admission before starting therapy, day 7 of treatment, the day of planned discharge (day 10-14), and 8 weeks after discharge.
We analyzed data from 135 patients; 78 (57.8%) were non-frequent exacerbators and 57 (42.2%) were frequent exacerbators. In both groups, the inflammatory and clinical indices at day 7, the day of planned discharge (day 10-14), and 8 weeks were significantly improved compared to those at admission. Frequent exacerbators had a smaller reduction in their inflammatory indices and CAT scores between exacerbation onset and all the other time points compared with infrequent exacerbators.
Frequent exacerbators have a reduced response to treatment of AECOPD in terms of inflammatory indices and quality of life.
当慢性阻塞性肺疾病急性加重（AECOPD）频繁发生时，患者气道和全身炎症水平较高，生活质量较差。本研究比较了频繁急性加重患者与非频繁急性加重患者在AECOPD期间全身和气道炎症的性质及病程。
连续纳入住院的AECOPD患者，并根据他们上一年经历AECOPD的频率分为两组。频繁急性加重者（定义为上一年发生2次或更多次AECOPD）和非频繁急性加重者（定义为上一年发生0次或1次AECOPD）。在开始治疗前的入院当天、治疗第7天、计划出院日（第10 - 14天）和出院后8周评估炎症指标（白细胞介素6、白细胞介素8、髓过氧化物酶和C反应蛋白）和临床指标（呼吸困难、慢性阻塞性肺疾病评估测试（CAT）和呼气峰值流速）。
我们分析了135例患者的数据；78例（57.8%）为非频繁急性加重者，57例（42.2%）为频繁急性加重者。两组在治疗第7天、计划出院日（第10 - 14天）和8周时的炎症和临床指标与入院时相比均有显著改善。与非频繁急性加重者相比，频繁急性加重者在急性加重发作至所有其他时间点的炎症指标和CAT评分下降幅度较小。
就炎症指标和生活质量而言，频繁急性加重者对AECOPD治疗的反应较差。
