Clinical efficacy of inhaled glucocorticoids combined with Streptococcus pneumoniae vaccines for acute exacerbation of chronic obstructive pulmonary disease in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To evaluate the clinical efficacy of inhaled corticosteroids combined with Streptococcus pneumoniae vaccines for acute exacerbation of chronic obstructive pulmonary disease in elderly patients.Methods A total of 150 elderly patients with chronic obstructive pulmonary disease were enrolled in this study from February 2014 to May 2016 at our hospital.All patients were randomly divided into three groups with 50 cases in each group.All patients received routine therapy.Meanwhile,patients in Group A were also treated with inhaled corticosteroids,patients in Group B were given pneumococcal vaccines,and patients in Group C received inhaled corticosteroids combined with Streptococcus pneumoniae vaccines.Clinical symptom improvement,pulmonary function,frequency of acute attacks,mortality and adverse reactions were compared between the three groups.Results There were no severe adverse reactions observed in Group C after vaccination.After treatment,incidences of cough,asthma and expectoration in both Group B and Group C were significantly lower than those in Group A (P＜ 0.05).However,there was no statistically significant difference between Group C and Group B(P＞0.05).Before treatment,levels of FEV1 and FEV1/FVC were comparable between the three groups(P＞0.05).However,after treatment,FEV1 (F =2.301,P =0.396) and FEV1/FVC (F =1.290,P =0.266) of the three groups were significantly improved compared with pre-treatment levels.Moreover,FEV1 and FEV1/FVC in Group B and Group C were significantly higher than those in Group A,and FEV1 and FEV1/FVC in Group C were significantly higher than those in Group B(P＜0.05).In addition,the incidence of acute exacerbation,the frequency and duration of hospitalization in Group B and Group C were significantly lower than in Group A,and acute attack intervals in Group B and Group C were significantly longer than inGroup A (all P ＜ 0.05).Furthermore,the incidence of acute exacerbation,the frequency and duration of hospitalization in Group C were significantly lower than in Group B,and acute attack intervals in Group C were significantly longer than inGroup B(all P＜0.05).During follow-up,there were not statistically significant differences in mortality between the groups(P＞0.05).Conclusions The combination of inhaled corticosteroids with Streptococcus pneumoniae vaccines is effective and safe for the treatment of acute exacerbation of chronic obstructive pulmonary disease in elderly patients.