The effect of oral glucocorticoids in different parts of emphysema

Abstract

Objective To investigate the effect of oral glucocorticoids in different parts of emphysema. Methods From January to December 2016, 80 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who received oral glucocorticoid in Department of Respiratory Medicine Chengdu Second People′s Hospital were randomly selected as the hormone group.40 patients with AECOPD who were not given glucocorticoid therapy in the same period were selected as the control group.Changes of modified British medical research council (mMRC) and chronic obstructive pulmonary disease assessment test (CAT) scores before and after glucocorticoid treatment were compared between the two groups.Hormone group patients were divided into upper emphysema group and lower emphysema group according to thoracic High Resolution CT results.Changes in mMRC and CAT scores before and after glucocorticoid treatment were compared between the this two groups. Results There was no significant difference in mMRC, CAT, white blood cell (WBC), and C-reactive protein (CRP) levels between the hormone group and the control group at admission.The difference of mMRC, CAT and CRP between the hormone group and the control group was statistically significant (t=5.681, 2.234, 3.238, all P<0.05). There was no significant difference in mMRC, CAT, WBC and CRP levels between the upper emphysema group and the lower emphysema group.There was a significant difference in mMRC and CAT between upper emphysema group and lower emphysema group after 5 days of treatment (t=2.980, 2.267, both P<0.05). Conclusions Oral glucocorticoids is better for emphysema in AECOPD patients with predominantly lower lobes. Key words: Chronic obstructive pulmonary disease, acute exacerbation; Emphysema; Glucocorticoid; Modified British medical research council; Chronic obstructive pulmonary disease assessment test