摘要
目的探讨吸入性糖皮质激素(inhaled corticosteroids,ICS)联合长效β_(2)受体激动剂(long-actingβ_(2)-adrenoceptor agonist,LABA)治疗在不同水平嗜酸性粒细胞(eosinophil,EOS)焦虑、抑郁慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者中的应用效果。方法选取2022年1月至2023年2月于高安市人民医院接受治疗的50例COPD患者作为研究对象,患者均存在焦虑、抑郁状况,按照入院时外周血EOS绝对数分为两组,每组25例。A组外周血EOS绝对数≥300个/μl,B组外周血EOS绝对数<300个/μl,两组均接受ICS联合LABA治疗。比较两组治疗前后呼吸困难量表(modified version of british medical research council dyspnea scale,mMRC)评分、COPD评估测试量表(COPD assessment test,CAT)评分、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分及肺功能指标[第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))、FEV_(1)占预计值百分比(the percentage of FEV_(1)predicted,FEV_(1)%)、用力肺活量(forced vital capacity,FVC)、FEV_(1)/FVC]。结果治疗后,两组FEV_(1)%、FEV_(1)/FVC均高于治疗前,B组FEV_(1)小于治疗前,A组FEV_(1)大于B组,差异有统计学意义(P<0.05);治疗后,两组mMRC评分均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05);治疗后,两组CAT评分均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05);治疗后,两组HAMA、HAMD评分均低于治疗前,且A组低于B组,差异有统计学意义(P<0.05)。结论EOS水平较高焦虑、抑郁COPD患者应用ICS联合LABA治疗的效果较好,能更好地改善肺功能,缓解临床症状,减轻焦虑、抑郁程度,提高生命质量,值得临床推广应用。
Objective To evaluate the efficacy of inhaled corticosteroids(ICS)combined with long-acting β_(2)-adrenergic agonists(LABA)in the treatment of patients with different levels of eosinophilic(EOS)chronic obstructive pulmonary disease(COPD)complicated with anxiety and depression.Methods 50 COPD patients treated at Gaoan People's Hospital from January 2022 to February 2023 were selected as the study subjects,all patients had anxiety and depression,they were divided into the two groups according to the absolute number of peripheral blood EOS at admission,with 25 cases in each group.The absolute number of EOS in peripheral blood of the group A was≥300/μl,and the absolute number of EOS in peripheral blood of the group B was<300/μl,both groups received ICS combined with LABA treatment.The scores of the modified version of british medical research council dyspnea scale(mMRC),COPD assessment test(CAT),Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),and pulmonary function indices(forced expiratory volume in one second[FEV_(1)],the percentage of FEV_(1) predicted[FEV_(1)%],forced vital capacity[FVC],FEV_(1)/FVC)between the two groups before and after treatment.Results After treatment,FEV_(1)%and FEV_(1)/FVC of the two groups were higher than those before treatment,FEV_(1) in the group B was lower than that before treatment,and FEV_(1) in the group A was greater than that in the group B,and the differences were statistically significant(P<0.05).After treatment,the mMRC scores of the two groups were lower than that before treatment,and the group A was lower than the group B,and the differences were statistically significant(P<0.05).After treatment,the CAT scores of the two groups were lower than that before treatment,and the group A was lower than the group B,and the differences were statistically significant(P<0.05).After treatment,the HAMA and HAMD scores of the two groups were lower than those before treatment,and the the group A was lower than the group B,and the differences were statistically significant(P<0.05).Conclusion The application of ICS combined with LABA in COPD patients with high EOS levels combined anxiety and depression has a better therapeutic effect,it can better improve lung function,relieve clinical symptoms,reduce the degree of anxiety and depression,and prolong life quality,it is worthy of clinical promotion and application.
作者
高康阳
黄斌
淦鑫
GAO Kangyang;HUANG Bin;GAN Xin(Department of Respiratory and Critical Care Medicine,Gaoan People's Hospital,Yichun,Jiangxi,330800,China;Department of Respiratory and Critical Care Medicine,First Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330004,China)
出处
《当代医学》
2025年第7期145-149,共5页
Contemporary Medicine
基金
江西省宜春市科技计划项目(2023ZDJH2893)。
