慢性阻塞性肺疾病患者急性加重或新型冠状病毒感染的临床和实验室特征的比较分析

E. Kulik, V. Pavlenko, S. Naryshkina
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引用次数: 0

摘要

的目标。考虑急性期血液参数的活动性,分析慢性阻塞性肺疾病(COPD)患者呼吸系统症状的严重程度,取决于是否存在急性加重或新型冠状病毒感染(NCVI)。材料和方法。研究了162例COPD患者的医学文献,将其分为3组:1组(n=61) - COPD和NCVI, 2组(n=53) -稳定期COPD, 3组(n=48) - COPD加重。呼吸道症状的严重程度采用积分法评估。采用c反应蛋白(CRP)、纤维蛋白原(g/L)等生化指标评价炎症活性。根据咳嗽严重程度和mMRC呼吸困难程度,第一、第二、第三组比较,差异无统计学意义(p=0.07)。第一组患者(82.5%)的特点是没有COPD加重的经典标准。在产痰严重程度上,第一组、第二组和第三组有统计学差异(p=0.0001)。第一组、第二组和第三组血清CRP (p=0.0001)和纤维蛋白原(p=0.009)水平差异有统计学意义。根据相关分析结果,发现呼吸道症状与CRP、纤维蛋白原水平有一定关系。稳定期COPD和NCVI相关病程的临床特征是存在严重呼吸困难和缺乏COPD加重的经典标准。NCVI和稳定期COPD的全身性炎症比孤立的稳定期COPD或加重期更明显,并与咳嗽和呼吸困难相关。从业人员可以利用所获得的数据对稳定型COPD的NCVI进行鉴别诊断。
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Comparative analysis of clinical and laboratory features in patients with chronic obstructive pulmonary disease depending on the presence of an exacerbation or a novel coronavirus infection
Aim. To analyze of the severity of respiratory symptoms in patients with chronic obstructive pulmonary disease (COPD), depending on the presence of an exacerbation or novel coronavirus infection (NCVI), taking into account the activity of acute phase blood parameters.Materials and methods. The medical documentation of 162 patients with COPD was studied, which were divided into 3 groups: group 1 (n=61) ‒ COPD and NCVI, group 2 (n=53) – stable COPD, group 3 (n=48) ‒ COPD exacerbation. The severity of respiratory symptoms was assessed using points. To assess the activity of inflammation the following biochemical indicators were used ‒ C-reactive protein (CRP) and fibrinogen (g/L).Results. According to the severity of cough and the intensity of dyspnea on the mMRC scale, the first, second and third groups did not differ statistically (p=0.07). Patients of the first group (82.5%) characterized by the absence of classical criteria for exacerbation of COPD. In terms of the severity of sputum production, the first, second and third groups are statistically different (p=0.0001). The first, second and third groups differ significantly in the level of serum CRP (p=0.0001) and fibrinogen (p=0.009). According to the results of the correlation analysis, some relationships found between respiratory symptoms and the level of CRP and fibrinogen.Conclusion. The clinical feature of the associated course of stable COPD and NCVI is the presence of severe dyspnea and the absence of classic criteria for exacerbation of COPD. Systemic inflammation in NCVI and stable COPD are more pronounced than in isolated stable COPD or exacerbation and correlates with cough and dyspnea. Practitioners for the differential diagnosis of NCVI in stable COPD can use the data obtained.
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