Objective To investigate the impact of proton pump inhibitors (PPIs) on risk of pneumonia in patients with chronic obstructive pulmonary disease (COPD).Methods From 2005 to 2015,a total of 39 019 patients with COPD were selected in In-patient Department,Outpatient Clinic and Emergency Department of Jiangbei Branch of Xiehe Hospital,Affiliated to Huazhong University of Science and Technology,and they were divided into A group (did not use PPIs,n =19232) and B group (used PPIs,n =19 787) according to the usage of PPIs.Patients of the two groups received conventional and symptomatic treatment.Clinical features and incidence of pneumonia were compared between the two groups,and incidence of pneumonia was observed in patients using different types of PPIs and different usage of PPIs.Results No statistically significant differences of gender,age,incidence of coronary heart disease,hypertension,diabetes,heart failure,chronic kidney diseases or chronic bowel disease,smoking history,drinking history or utilization rate of glucocorticoids was found between the two groups (P ＞0.05).Incidence of pneumonia of A group was statistically significantly lower than that of B group (P ＜ 0.05).Have statisticall significant differences of pneumonia incidence in the patients with COPD different types and different usage of PPIs (P＜ 0.05)..Conclusion PPIs may increase the risk of pneumonia in patients with COPD,and types and usage of PPIs may affect the risk of pneumonia in patients with COPD;in patients with COPD,as the usage of PPIs increases,the risk of pneumonia increases.%目的 探讨质子泵抑制剂(PPIs)对慢性阻塞性肺疾病(COPD)患者肺炎发生风险的影响.方法 选取2005-2015年武汉市华中科技大学附属协和医院江北分院住院部、门诊和急诊收治的COPD患者39 019例,根据PPIs使用情况分为A组19 232例(未使用PPIs)与B组19 787例(使用PPIs).两组患者均予以常规治疗和对症治疗.比较两组患者临床特征和肺炎发生率,并观察使用不同类型PPIs、不同剂量PPIs的COPD患者肺炎发生情况.结果 两组患者性别、年龄、冠心病发生率、高血压发生率、糖尿病发生率、心力衰竭发生率、慢性肾脏病发生率、慢性肠病发生率、吸烟史、饮酒史、糖皮质激素使用率比较,差异无统计学意义(P＞0.05).B组患者肺炎发生率高于A组(P＜0.05).使用不同类型和不同剂量PPIs的COPD患者肺炎发生率比较,差异有统计学意义(P＜0.05).结论 PPIs可能增加COPD患者肺炎发生风险,PPIs类型和使用剂量可能影响COPD患者肺炎发生风险,随PPIs使用剂量增加,肺炎发生风险升高.
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