TY - JOUR T1 -吸入性皮质类固醇对肺炎并发COPD患者预后的影响JF -欧洲呼吸杂志JO - Eur Respir J SP - 36 LP - 41 DO - 10.1183/09031936.00077010 VL - 38 IS - 1 AU - Singanayagam, a.au - Chalmers, J.D. AU - Akram, A.R. AU - Hill，A.T. Y1 - 2011/07/01 UR - //www.qdcxjkg.com/content/38/1/36.abstract N2 -这项研究的目的是调查吸入性皮质类固醇(ICS)的使用是否会影响合并社区获得性肺炎(CAP)的慢性阻塞性肺病(COPD)患者的预后。这是一项前瞻性的观察性研究，研究对象是英国洛锡安地区经肺活量测定确诊的COPD患者，主要诊断为CAP。比较ICS使用者和非ICS使用者的结果指标。在纳入研究的490名患者中，76.7%被归类为ICS使用者。与非ICS用户相比，ICS用户的全球慢性阻塞性肺疾病(GOLD)阶段更高(平均值±标准差3.2±0.8 vs . 2.6±0.9;术中,0.0001)。肺炎严重程度指数(PSI) 4.2±0.8 vs 4.3±0.8 (p = 0.3);mean±sd CURB-65评分2.1±1.3 vs 2.3±1.3 (p = 0.07))或全身炎症标志物(中位数c反应蛋白148(四分位范围58-268)mg·L−1 vs 183 (IQR 85-302) mg·L−1;p = 0.08)。 On multivariable analysis, after adjustment for COPD severity and PSI, ICS use was not independently associated with 30-day mortality (OR 1.71, 95% CI 0.75–3.90; p = 0.2), 6-month mortality (OR 1.62, 95% CI 0.82–3.16; p = 0.2), requirement for mechanical ventilation and/or inotropic support (OR 0.73, 95% CI 0.33–1.62; p = 0.4) or development of complicated pneumonia (OR 0.71, 95% CI 0.25–1.99; p = 0.5). Prior ICS use had no impact on outcome in patients with COPD admitted with CAP. ER -