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首页> 外文期刊>Respirology : >Airway inflammation and anti-protease defences rapidly improve during treatment of an acute exacerbation of COPD.
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Airway inflammation and anti-protease defences rapidly improve during treatment of an acute exacerbation of COPD.

机译：在治疗COPD急性加重期间，气道炎症和抗蛋白酶防御迅速改善。

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BACKGROUND AND OBJECTIVE: There are few data on the short-term natural history of airway inflammation during severe episodes of acute exacerbation of COPD (AECOPD). An observational study was performed to determine how rapidly conventional treatment improves airway inflammation in patients admitted to hospital with AECOPD. METHODS: Twenty-four consecutive patients with AECOPD were recruited and changes in sputum inflammatory indices were assessed after 2 and 4 days of treatment. The primary end-points included presence of bacteria and viruses, changes in sputum total cell counts (TCC) and polymorphonuclear leukocyte (PMN) differential counts, and levels of secretory leukocyte protease inhibitor (SLPI), IL-8 and TNF-alpha. RESULTS: All patients received oral corticosteroids and 17 (71%) were also treated with oral antibiotics. A bacterial or viral pathogen was isolated from 12 patients (50%), and Aspergillus fumigatus was isolated from one. A positive bacterial culture was associated with increased sputum TCC and PMN count (P < 0.05), as well as higher levels of IL-8 and TNF-alpha (P < 0.05), and a trend towards lower sputum SLPI levels (P = 0.06). Sputum PMN numbers fell by 70% within the first 48 h of admission (P < 0.05), accompanied by an increase in sputum SLPI (P < 0.001) and reductions in the levels of TNF-alpha (P < 0.005) and IL-8 (P = 0.06), with no further significant change at 4 days. CONCLUSIONS: Conventional treatment for severe AECOPD is associated with rapid reduction of neutrophilic inflammation and improvement in anti-protease defences.
机译：背景与目的：在COPD急性加重（AECOPD）严重发作期间，气道炎症的短期自然病史资料很少。进行了一项观察性研究，以确定常规治疗如何快速改善AECOPD住院患者的气道炎症。方法：招募了24例AECOPD患者，并在治疗2天和4天后评估了痰中炎症指标的变化。主要终点包括细菌和病毒的存在，痰总细胞计数（TCC）和多形核白细胞（PMN）差异计数的变化，以及分泌性白细胞蛋白酶抑制剂（SLPI），IL-8和TNF-α的水平。结果：所有患者均接受口服糖皮质激素治疗，其中17例（71％）也接受了口服抗生素治疗。从12名患者（50％）中分离出细菌或病毒病原体，并从一名患者中分离出烟曲霉。细菌培养阳性与痰中TCC和PMN计数增加（P <0.05），以及IL-8和TNF-α的水平升高（P <0.05），以及痰液中SLPI水平降低的趋势有关（P = 0.06）。 ）。入院后48小时内痰中PMN数量下降了70％（P <0.05），同时痰中SLPI升高（P <0.001）和TNF-α水平降低（P <0.005）和IL-8 （P = 0.06），在4天时没有进一步的显着变化。结论：重度AECOPD的常规治疗与中性粒细胞炎症的快速减少和抗蛋白酶防御的改善有关。

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