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目的分析严重哮喘急性发作给予适当治疗后,引起肺功能恢复时间延长的相关因素。方法回顾性分析2013年12月—2016年7月新疆医科大学第一附属医院急诊科收治的51例哮喘急性发作患者。收集患者入院前及入院时有关临床指标,并运用统计学软件对数据进行分析。结果共有51例符合入组标准,男25例;平均年龄(52.2±18.9)岁;其中肥胖患者(BMI>30 kg/m2)28例;既往有哮喘的患者27例;哮喘急性发作前规律使用糖皮质激素15例;伴有心脏病7例,伴有糖尿病12例,伴有过敏性鼻炎患者28例;入院后,需给予吸氧治疗29例,并发肺炎20例,并发呼吸道病毒感染18例;患者出院时肺功能优于入院时,差异有统计学意义(P<0.001);51例患者的肺功能恢复时间范围较宽,为1~12 d,平均恢复时间(6.6±2.5)d;单因素分析显示哮喘急性发作前规律使用糖皮质激素(P<0.001),入院期间并发呼吸道病毒性感染(P<0.001),过敏性鼻炎(P=0.009)会导致肺功能恢复时间延长;多因素COX比例风险回归分析结果显示哮喘急性发作前规律使用糖皮质激素、入院时并发呼吸道病毒性感染与肺功能恢复时间延长具有相关性(P<0.05)。结论哮喘急性发作后肺功能恢复的时间在不同患者之间是不同的,长期使用糖皮质激素以及并发呼吸道病毒感染是影响恢复时间的重要因素。
Objective To analyze the related factors that lead to prolonged pulmonary function recovery after proper treatment of severe acute asthma attacks. Methods A retrospective analysis of 51 cases of acute exacerbation of asthma admitted to the Emergency Department of the First Affiliated Hospital of Xinjiang Medical University from December 2013 to July 2016 was conducted. Collect the clinical indexes of patients before admission and on admission, and use statistical software to analyze the data. Results A total of 51 patients met the inclusion criteria, including 25 males and 52.2 ± 18.9 years of age, including 28 obese patients (BMI> 30 kg / m2), 27 patients with previous asthma, and pre-asthma exacerbations 15 cases of glucocorticoid; 7 cases accompanied by heart disease, 12 cases with diabetes mellitus, 28 cases with allergic rhinitis; After admission, need to give oxygen therapy in 29 cases, complicated by pneumonia in 20 cases, complicated by respiratory virus infection in 18 cases (P <0.001). The recovery time of pulmonary function in 51 patients ranged from 1 to 12 days with an average recovery time of (6.6 ± 2.5) days. Univariate analysis showed that the regular use of glucocorticoids (P <0.001) before acute exacerbation of asthma complicated respiratory viral infection during admission (P <0.001) and allergic rhinitis (P = 0.009) COX proportional hazards regression analysis showed that the regular use of glucocorticoids before acute exacerbation of asthma was associated with prolonged pulmonary function recovery (P <0.05) on admission with respiratory viral infection. Conclusions The duration of pulmonary function recovery after acute asthma attack varies among patients. Long-term use of glucocorticoids and concurrent respiratory virus infection are important factors that influence the recovery time.