https://scholars.lib.ntu.edu.tw/handle/123456789/512229
Title: | Elevated placenta growth factor predicts pneumonia in patients with chronic obstructive pulmonary disease under inhaled corticosteroids therapy | Authors: | Cheng S.-L. HAO-CHIEN WANG SHIH-JUNG CHENG CHONG-JEN YU |
Issue Date: | 2011 | Journal Volume: | 11 | Start page/Pages: | 46 | Source: | BMC Pulmonary Medicine | Abstract: | Background: An increased incidence of pneumonia in patients with chronic obstructive pulmonary disease (COPD) under inhaled corticosteroid (ICS) therapy was noticed in previous studies. We performed a prospective study to elucidate the risk factors for the development of pneumonia in this group of patients.Methods: A prospective, non-randomized study with patients diagnosed as having COPD from 2007 to 2008 identified in the Far Eastern Memorial Hospital were recruited. We recorded data for all patients, including clinical features and signs, demographic data, lung function status, and medications. Bio-markers such as C-reactive protein (CRP) and placenta growth factor (PlGF) were checked at first diagnosis. Every acute exacerbation was also recorded, especially pneumonia events, which were confirmed by chest radiography. Multivariate analysis was performed with stepwise logistic regression for pneumonia risk factors.Results: 274 patients were diagnosed as having COPD during the study period and 29 patients suffered from pneumonia with a prevalence of 10.6%. The rate was significantly higher in patients with ICS therapy (20/125, 16%) compared with those without ICS (9/149, 6%) (p = 0.02). We stratified ICS therapy into medium dose (500-999 ug/day fluticasone equivalent, 71 patients) and high dose (1000 ug/day and higher fluticasone equivalent, 54 patients) group. There was no statistical difference in the incidence of pneumonia between these two group (medium dose: 13/71, 18.3% vs. high dose: 7/54, 12.9%, p = 0.47). Multivariate analysis was performed to identify the risk factors for developing pneumonia and included forced expiratory volume in one second (FEV1) less than 40% of predicted (odds ratio (OR) 2.2, 95% confidence interval (CI): 1.1-6.9), ICS prescription ((OR) 2.4, 95% (CI): 1.3-8.7), the presence of diabetes mellitus (DM) (OR 2.6, 95% CI: 1.2-9.4) and PlGF level over 40 pg/L (OR 4.1, 95% CI: 1.5-9.9).Conclusion: ICS therapy in patients with COPD increased the risk of pneumonia. However, there was no relationship between the incidence of pneumonia and dosage of ICS. Additionally, advanced COPD status, DM and elevated PlGF level were independent risk factors for the development of pneumonia. PlGF would be a good novel biomarker for predicting pneumonia. ? 2011 Cheng et al; licensee BioMed Central Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-80053346677&doi=10.1186%2f1471-2466-11-46&partnerID=40&md5=8508a0ca30774be9d1b41f15def57799 https://scholars.lib.ntu.edu.tw/handle/123456789/512229 |
ISSN: | 1471-2466 | DOI: | 10.1186/1471-2466-11-46 | SDG/Keyword: | beclometasone; beta adrenergic receptor stimulating agent; budesonide; C reactive protein; fluticasone; placental growth factor; biological marker; C reactive protein; glucocorticoid; placenta protein; placental growth factor; adult; aged; article; chronic obstructive lung disease; clinical feature; clinical trial; controlled study; corticosteroid therapy; diabetes mellitus; disease exacerbation; drug dose comparison; drug megadose; female; forced expiratory volume; human; incidence; lung function; major clinical study; male; pneumonia; prevalence; prospective study; protein blood level; thorax radiography; blood; chemically induced disorder; chronic obstructive lung disease; inhalational drug administration; middle aged; pathophysiology; risk factor; Administration, Inhalation; Biological Markers; C-Reactive Protein; Female; Glucocorticoids; Humans; Male; Middle Aged; Pneumonia; Pregnancy Proteins; Pulmonary Disease, Chronic Obstructive; Risk Factors |
Appears in Collections: | 醫學系 |
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