吸入性皮质类固醇添加到全身类固醇对COPD恶化结果的影响
Eyal Kleinhendler1, Noa Shopen2, Neta Cohen2
1Division of Pulmonary Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. eyalkl@tlvmc.gov.il.
将吸入性皮质类固醇 (ICS) 添加到全身类固醇治疗COPD恶化并没有改善死亡率或住院等结果. 治疗应该是个性化的,因为ICS在这些急性阶段没有额外的好处.
科学领域:
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性肺炎恶化严重导致患者的发病率和死亡率.
- 吸入性皮质类固醇 (ICS) 在COPD恶化期间作为全身类固醇的辅助剂的作用尚未得到充分证实.
研究的目的:
- 评估将ICS添加到COPD恶化的标准系统性类固醇治疗中的影响.
- 评估对住院时间,输管率和30天死亡率的影响.
主要方法:
- 对870名因COPD恶化而入院的患者进行了回顾性观察性研究.
- 倾向性得分匹配被用来比较患者接受系统性类固醇与或没有ICS.
主要成果:
- 在匹配后,在30天死亡率 (7.1%对5.8%) 或组之间的二次结果中没有发现显著差异.
- 根据乙氨基酸水平对子组的分析没有改变这些发现.
- 在多变量分析中,低胆固醇细胞数 (<150细胞/μL) 和高查尔森得分独立预测了30天死亡率.
结论:
- 吸入性皮质类固醇 (ICS) 在与全身类固醇结合治疗COPD恶化时没有提供额外的益处.
- 需要个性化治疗策略,需要进一步研究ICS在COPD恶化中的作用.
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