Inhaled Steroids, Circulating Eosinophils, Chronic Airway Infection, and Pneumonia Risk in Chronic Obstructive Pulmonary Disease A Network Analysis
Inhaled Steroids, Circulating Eosinophils, Chronic Airway Infection, and Pneumonia Risk in Chronic Obstructive Pulmonary Disease A Network Analysis
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吸入类固醇、循环嗜酸性粒细胞、慢性气道感染和慢性阻塞性肺疾病肺炎风险的网络分析
DOI：
10.1164/rccm.201908-1550oc
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发表时间：
2020-05-01
影响因子：
24.7
通讯作者：
Agusti, Alvar
中科院分区：
文献类型：
--
作者：
Angel Martinez-Garcia, Miguel;Faner, Rosa;Agusti, Alvar
理由：用吸入皮质类固醇 (ICS) 治疗慢性阻塞性肺疾病 (COPD) 存在争议，因为它可以降低疾病未来恶化的风险，但会增加肺炎风险。目的：评估慢性支气管感染 (CBI) 的存在、循环嗜酸性粒细胞数量减少、ICS 治疗与 COPD 患者肺炎风险之间的关系。方法：这是一项事后长期研究这是一项对 201 名 COPD（慢性阻塞性肺病 H-IV 全球倡议）患者的历史队列进行的观察性研究，这些患者经过仔细的特征分析（包括气道微生物学）并进行了中位 84 个月的随访。结果通过多变量Cox回归和网络分析进行分析。测量和主要结果：平均年龄为70.3岁，90.5%的患者为男性，平均FEV1为49%，71.6%的患者接受ICS治疗，其中57.2%患有支气管扩张，20.9%患有支气管扩张。
Rationale: Treatment of chronic obstructive pulmonary disease (COPD) with inhaled corticosteroids (ICS) is controversial, because it can reduce the risk of future exacerbations of the disease at the expense of increasing the risk of pneumonia.Objectives: To assess the relationship between the presence of chronic bronchial infection (CBI), reduced number of circulating eosinophils, ICS treatment, and the risk of pneumonia in patients with COPD.Methods: This was a post hoc long-term observational study of an historical cohort of 201 patients with COPD (Global Initiative for Chronic Obstructive Lung Disease H-IV) who were carefully characterized (including airway microbiology) and followed for a median of 84 months. Results were analyzed by multivariate Cox regression and network analysis.Measurements and Main Results: Mean age was 70.3 years, 90.5% of patients were male, mean FEV1 was 49%, 71.6% of patients were treated with ICS, 57.2% of them had bronchiectasis, and 20.9% had