[1]吴梦琪,李 秀.外周血嗜酸性粒细胞在慢性阻塞性肺病急性加重中的临床价值[J].医学信息,2021,34(01):108-111.[doi:10.3969/j.issn.1006-1959.2021.01.028]
　WU Meng-qi,LI Xiu.The Clinical Value of Peripheral Blood Eosinophils in Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Medical Information,2021,34(01):108-111.[doi:10.3969/j.issn.1006-1959.2021.01.028]
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外周血嗜酸性粒细胞在慢性阻塞性肺病急性加重中的临床价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年01期
页码:
108-111
栏目:
论著
出版日期:
2021-01-01

文章信息/Info

Title:
The Clinical Value of Peripheral Blood Eosinophils in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
文章编号:
1006-1959（2021）01-0108-04
作者:
吴梦琪; 李 秀
（1.安徽医科大学，安徽 合肥 230031； 2.安徽医科大学第三附属医院呼吸内科，安徽 合肥 230031）
Author(s):
WU Meng-qi; LI Xiu
(1.Anhui Medical University,Hefei 230031,Anhui,China; 2.Department of Respiratory Medicine,the Third Affiliated Hospital of Anhui Medical University,Hefei 230031,Anhui,China)
关键词:
慢性阻塞性肺病急性加重; 外周血嗜酸性细胞; 糖皮质激素
Keywords:
Acute exacerbation of chronic obstructive pulmonary disease; Peripheral blood eosinophils; Glucocorticoids
分类号:
R563
DOI:
10.3969/j.issn.1006-1959.2021.01.028
文献标志码:
A
摘要:
目的 探讨外周血嗜酸性粒细胞（EOS）在慢性阻塞性肺病急性加重（AECOPD）中的临床价值。方法 选取2018年7月~2019年6月安徽医科大学第三附属医院呼吸内科住院的AECOPD患者105例作为研究对象，依据患者入院时血常规中外周血嗜酸性粒细胞百分比（EOS%）分为阳性组（EOS%＞2%）46例，阴性组（EOS%≤2%）59例，分析两组一般资料、糖皮质激素使用情况、住院天数、1年内急性加重次数及病死率。结果 两组年龄、性别、COPD病程、吸烟史、CAT评分、BMI、合并症、FEV1/FVC、FEV1%比较，差异均无统计学意义（P＞0.05）；阳性组WBC、CRP、PCT均低于阴性组，FENO值高于阴性组，差异有统计学意义（P＜0.05）。相关性分析显示，EOS%与FENO存在正相关（r=0.183，P=0.031）。两组住院期间在糖皮质激素使用总天数、雾化吸入激素天数及雾化激素累积剂量比较，差异无统计学意义（P＞0.05）；阳性组静脉激素使用天数及静脉激素累积剂量低于阴性组，差异有统计学意义（P＜0.05）。两组1年内加重次数及病死率比较，差异无统计学意义（P＞0.05）；阳性组住院时间短于阴性组，差异有统计学意义（P＜0.05）。结论 阴性组患者感染情况更重，糖皮质激素治疗效果更差，住院时间更长。外周血嗜酸性粒细胞在帮助判断AECOPD患者的病情、指导激素治疗及评估预后方面具有重要的临床价值。
Abstract:
Objective To investigate the clinical value of peripheral blood eosinophils(EOS) in acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Methods From July 2018 to June 2019, 105 patients with AECOPD who were hospitalized in the Department of Respiratory Medicine of the Third Affiliated Hospital of Anhui Medical University were selected as the research objects. According to the blood routine of the patients at the time of admission, the percentage of eosinophils in the peripheral blood (EOS%) was classified as positive There were 46 cases in the group (EOS%>2%) and 59 cases in the negative group (EOS%≤2%). The general information of the two groups, the use of glucocorticoids, the length of hospital stay, the number of acute exacerbations within one year and the mortality rate were analyzed.Results There was no significant difference in age, gender, course of COPD, smoking history, CAT score, BMI, comorbidities, FEV1/FVC, FEV1% between the two groups (P>0.05); the positive group WBC, CRP, PCT were all lower than In the negative group, the FENO value was higher than that in the negative group,the difference was statistically significant(P<0.05).Correlation analysis showed that EOS% was positively correlated with FENO (r=0.183,P=0.031). There was no statistically significant difference in the total number of days of glucocorticoid use, days of nebulized inhalation of hormones and cumulative dose of nebulized hormones between the two groups during hospitalization (P>0.05); the number of days of intravenous hormone use and the cumulative dose of intravenous hormone in the positive group were lower than the negative group, the difference was statistically significant (P<0.05). There was no statistically significant difference in the number of exacerbations and mortality between the two groups within 1 year (P>0.05); the hospital stay in the positive group was shorter than that in the negative group,the difference was statistically significant (P<0.05).Conclusion Patients in the negative group have more severe infections, worse effects of glucocorticoid therapy, and longer hospital stays. Peripheral blood eosinophils have important clinical value in helping to determine the condition of AECOPD patients, guiding hormone therapy and assessing the prognosis.

参考文献/References:

[1]Hurst JR,Vestbo J,Anzueto A,et al.Susceptibility to exacerbation in chronic obstructive pulmonary disease[J].N Engl J Med,2010(363):1128-1138. [2]Vedel-Krogh S,Nielsen SF,Lange P,et al.Blood eosinophils and exacerbations in COPD:the Copenhagen general population study[J].Am J Respir Crit Care Med,2015,193(9):965. [3]Singh D,Agusti A,Anzueto A,et al.Global strategy for the diagnosis,management,and prevention of chronic obstructive lung disease:the GOLD science committee report 2019[J].Eur Respir J,2019(53):1. [4]Vogelmeier CF,Criner GJ,Martinez FJ,et al.Global Strategy for the Diagnosis,Management,and Prevention of Chronic Obstructive Lung Disease 2017 Report[J].Archivos de Bronconeumología,2017,53(3):557. [5]慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组.慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017年更新版)[J].国际呼吸杂志,2017,37(14):1041. [6]Ko FWS,Chan KP,Ngai J,et al.Blood eosinophil count as a predictor of hospital length of stay in COPD exacerbations[J].Respirology,2020,25(3):259-266. [7]Choi J,Oh JY,Lee YS,et al.The association between blood eosinophil percent and bacterial infection in acute exacerbation of chronic obstructive pulmonary disease[J].Int J Chron Obstruct Pulmon Dis,2019(14):953-959. [8]Stanescu D,Sanna A,Veriter C,et al.Airways obstruction,chronic expectoration,and rapid decline of FEV1 in smokers are associated with increased levels of sputum neutrophils[J].Thorax,1996(51):267-271. [9]Barnes PJ.Inflammatory mechanisms in patients with chronic obstructive pulmonary disease[J].J Allergy Clin Immunol,2016(138):16-27. [10]Saetta M,Di Stefano A,Maestrelli P,et al.Airway eosinophilia in chronic bronchitis during exacerbations[J].Am J Respir Crit Care Med,1994(150):1646-1652. [11]Eltboli O,Mistry V,Barker B,et al.Relationship between blood and bronchial submucosal eosinophilia and reticular basement membrane thickening in chronic obstructive pulmonary disease[J].Respirology,2015(20):667-670. [12]Wagener AH,de Nijs SB,Lutter R,et al.External validation of blood eosinophils,Fe(NO)and serum periostin as surrogates for sputum eosinophils in asthma[J].Thorax,2015(70):115-120. [13]Tang B,Huang D,Wang J,et al.Relationship of Blood Eosinophils with Fractional Exhaled Nitric Oxide and Pulmonary Function Parameters in Chronic Obstructive Pulmonary Disease(COPD)Exacerbation[J].Med Sci Monit,2020(26):e921182. [14]Kostikas K,Brindicci C,Patalano F.Blood eosinophils as biomarkers to drive treatment choices in asthma and COPD[J].Curr Drug Targets,2018(19):1882-1896. [15]Bafadhel M,Greening NJ,Harvey-Dunstan TC,et al.Blood eosinophils and outcomes in severe hospitalised exacerbations of COPD[J].Chest,2016:S001236921600581X. [16]Greulich T,Tüffers J,Mager S,et al.High eosinophil blood counts are associated with a shorter length of hospital stay in exacerbatedCOPD patients-a retrospective analysis[J].Respir Res,2020,21(1):106. [17]Vedel-Krogh S,Nielsen SF,Lange P,et al.Blood Eosinophils and Exacerbations in Chronic Obstructive Pulmonary Disease.The Copenhagen General Population Study[J].American Journal of Respiratory&Critical Care Medicine,2016,193(9):965. [18]Barnes NC,Sharma R,Lettis S,et al.Blood eosinophils as a marker ofresponse to inhaled corticosteroids in COPD[J].Eur Respir J,2016(47):1374-1382. [19]Cheng SL.Blood eosinophils and inhaled corticosteroids in patients with COPD:systematic review and meta-analysis[J].Int J Chron Obstruct Pulmon Dis,2018(13):2775-2784. [20]Bafadhel M,Davies L,Calverley PM,et al.Blood eosinophil guided prednisolone therapy for exacerbations of COPD:a further analysis[J].Eur Respir J,2014(44):789-791. [21]Gendrel D,Raymond J,Coste J,et al.Comparison of procalcitonin with C-reactive protein,interleukin 6 and interferon-alpha for differentiation of bacterial vs.viral infections[J].Pediatr Infect Dis J,1999(18):875-881. [22]Schuetz P,Christ-Crain M,Thomann R,et al.Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections:the ProHOSP randomized controlled trial[J].JAMA,2009(302):1059-1066.

更新日期/Last Update: 1900-01-01