慢性阻塞性肺疾病急性加重期與慢性阻塞性肺疾病并發社區獲得性肺炎患者的臨床對比

許俊

摘 要：目的 探究慢性阻塞性肺疾病急性加重期與慢性阻塞性肺疾病并發社區獲得性肺炎患者的臨床對比，旨在為臨床的診斷和治療提供科學依據。方法 選取2017年3月～2018年3月于我院接受治療的82例COPD患者為研究對象，按照隨機數表法分為兩組，其中觀察組42例為AECOPD患者，對照組40例為COPD合并CAP患者，比較兩組患者的臨床癥狀、肺功能以及PCT、CRP水平。結果 觀察組患者呼吸困難、咳膿痰、精神差、發熱等臨床癥狀的發生率均低于對照組，差異具有統計學意義（P<0.05）。觀察組患者FEV1、FVC、FEV1/FVC分別為（64.15±7.26）ml、（62.85±7.29）ml、（62.03±5.54）%，均高于對照組的（52.51±5.75）ml、（50.85±6.74）ml、（52.34±5.61）%，差異具有統計學意義（P<0.05）。觀察組患者PCT和CRP分別為（0.52±0.07）ng/L和（21.51±1.35）mg/L，均低于對照組的（0.97±0.08）ng/L和（40.05±1.57）mg/L，差異具有統計學意義（P<0.05）。結論 AECOPD患者與COPD合并CAP患者相比，臨床癥狀發生情況較少，肺功能較好，對患者進行相關檢測，能夠提高治療效果。

關鍵詞：慢性阻塞性肺疾病；慢性阻塞性肺疾病急性加重期；社區獲得性肺炎；肺功能

中圖分類號：R563.9 文獻標識碼：A DOI：10.3969/j.issn.1006-1959.2018.22.033

文章編號：1006-1959（2018）22-0118-03

Clinical Comparison of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Chronic Obstructive Pulmonary Disease Complicated with Community Acquired Pneumonia

XU Jun

（Lishui Branch Hospital，Zhongda Hospital Affiliated to Southeast University/Department of Respiratory Medicine，

People's Hospital of Lishui District，Nanjing 211200，Jiangsu，China）

Abstract：Objective To investigate the clinical comparison between patients with acute exacerbation of chronic obstructive pulmonary disease and patients with chronic obstructive pulmonary disease complicated with community-acquired pneumonia， aiming at providing scientific evidence for clinical diagnosis and treatment. Methods 82 patients with COPD who were treated in our hospital from March 2017 to March 2018 were enrolled in the study. They were divided into two groups according to the random number table. Among them， 42 patients in the observation group were AECOPD patients，40 patients in the control group were treated with COPD and CAP. The clinical symptoms， lung function， and PCT and CRP levels were compared between the two groups. Results The incidence of clinical symptoms such as dyspnea， cough and sputum， mental retardation and fever were lower in the observation group than in the control group， the difference was statistically significant （P<0.05）. The FEV1， FVC and FEV1/FVC of the observation group were （64.15±7.26） ml， （62.85±7.29） ml， and （62.03±5.54）%， respectively， which were higher than the control group （52.51±5.75） ml， （50.85±6.74）ml， （52.34±5.61）%， the difference was statistically significant （P<0.05）. The PCT and CRP of the observation group were （0.52±0.07） ng/L and （21.51±1.35） mg/L， respectively， which were lower than those of the control group （0.97±0.08） ng/L and （40.05±1.57） mg/L，the difference was statistically significant （P<0.05）. Conclusion Compared with patients with COPD and CAP， AECOPD patients have fewer clinical symptoms and better lung function. Relevant tests can improve the treatment effect.

Key words：Chronic obstructive pulmonary disease；Acute exacerbation of chronic obstructive pulmonary disease；Community acquired pneumonia；Pulmonary function

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是由有害物質進入人體，對肺實質和肺間質造成的炎癥反應，當起病速度較快時，即發生慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease，AECOPD），在臨床上主要表現為咳嗽、咳痰并伴有發熱等癥狀[1，2]。社區獲得性肺炎（community acquired pneumonia，CAP）屬于患者在醫院外罹患的感染性疾病，其發病率高居不下，COPD患者與其他氣道疾病患者相比，CAP的患病率更高[3]。AECOPD和COPD合并CAP患者在臨床上的表現癥狀相似，難以鑒別，成為臨床上研究的難點[4]。本次研究通過對AECOPD患者和COPD合并CAP患者進行比較，發現其臨床癥狀和并發癥的發生率不同、肺功能狀況不同，現報道如下。

1資料與方法

1.1一般資料 選取2017年3月～2018年3月于南京市溧水區人民醫院接受治療的82例COPD患者為研究對象，本研究經醫院倫理會批準。納入標準：①符合參考《COPD診治指南2013年修訂版》中有關AECOPD和COPD合并CAP的診斷標準；……