ObjectiveTo evaluate the value of serum procalcitonin (PCT) level after conventional intravenous antibiotic treatment to predict the risk of re-exacerbation, and vertify the feasiblity of an additional course of oral antibiotics after discharge to reduce the risk of re-exacerbation. MethodsThe patients who hospitalized in West China Hospital from October 2012 to October 2013 because of infectious acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were recruited. The concentrations of PCT and C-reactive protein (CRP), the number of white blood cell (WBC) and neutrophil percentage at the end of intravenous antibiotic therapy were recorded. The information about additional course of antibiotics was collected according to the medical instruction and visit. The subjects were followed up for 1 year.The time to the first re-exacerbation and frequencies of exacerbations were recorded. The Cox regression model was used to estimate the hazard rations (HR). ResultsOne hundred and thirty-eight eligible patients were included totally. The HRs in PCT≥0.11μg/L and neutrophil percentage≥70% were 1.462 (P=0.035) and 1.673 (P=0.005) respectively, suggesting higher risk of re-exacerbation. There was no relationship of CRP (P=0.330) or WBC (P=0.432) with the risk of re-exacerbation. Generally an additional course of antibiotics had no effects on re-exacerbation (P=0.231) but this therapy could reduce the risk of re-exacerbation in high PCT level group (HR=2.29, P=0.004). ConclusionsSerum PCT concentrations and neutrophil percentage after conventional intravenous antibiotic treatment can predict the risk of re-exacerbations in the future. An additional course of antibiotics in the patients with high PCT level can reduce the risk of re-exacerbation.
ObjectiveTo survey the current asthma impact on quality of life and related factors in China. MethodsTwo thousand and thirty-four asthmatic patients, from bronchial asthma prevalence epidemiology survey in the population over 14 years old in 8 areas of China from 2009 to 2013, were enrolled. The data about medical resource use, control status and quality of life were collected by detailed questionnaire and analysed using the Epidata database and SAS 9.2 software. ResultsOut of the 2034 asthma patients, 1213 patients (59.6%) reported that their activities including entertainment, learning, fertility and employment were limited due to asthma. In the four aspects of entertainment, education, family and employment, 688 patients (33.8%) had one limited activity in one aspect, 165 patients (8.19%) had most of activities limited in one aspect, 246 patients (12.1%) had limited activities in two or three aspects, 114 patients (5.6%) had limited activities in all aspects. One hundred and eighty-one patients (8.9%) needed help in daily life, such as cooking, shopping, doing housework. Seventy-one patients (3.5%) even needed help in eating, personal hygiene, toilet, and their daily activities were remarkably restricted. Eighty-one patients (4.0%) had motive of suicide. Aging, comorbidity, and medication use were the most important factors. ConclusionAsthma has a significant negative effects on the life and emotion of patients, and proper control of comorbidity and regular treatment of asthma are effective ways to improve the life and emotional state of patients with asthma.