摘要
背景外周血嗜酸粒细胞百分比(EOS%)是嗜酸性气道炎症的敏感生物学标志物,但目前其与慢性阻塞性肺疾病(COPD)患者急性加重的关系尚存在争议。目的分析入院时外周血EOS%与慢性阻塞性肺疾病急性加重(AECOPD)患者出院后短期内急性加重复发的关系。方法选取2017年7月-2018年7月徐州医科大学附属医院呼吸内科收治的AECOPD患者197例,根据入院时外周血EOS%分为正常组(EOS%<2%,n=156)和升高组(EOS%≥2%,n=41)。比较两组患者肺功能指标〔包括第1秒用力呼气容积与用力肺活量比值(FEV1/FVC)、第1秒用力呼气容积占预计值的百分比(FEV1%pred)及GOLD分级〕、改良版英国医学研究会呼吸困难问卷(mMRC)分级、慢性阻塞性肺疾病评估测试(CAT)评分、出院后吸入性糖皮质激素(ICS)使用情况及出院后90 d内急性加重复发率。比较出院后90 d内有无急性加重复发患者一般资料、肺功能指标、mMRC分级、CAT评分、入院时外周血EOS%、出院后ICS使用情况;入院时外周血EOS%与AECOPD患者出院后90 d内急性加重复发的关系分析采用多因素Logistic回归分析。结果(1)两组患者FEV1%pred、GOLD分级、mMRC分级、CAT评分及出院后使用ICS者所占比例比较,差异无统计学意义(P>0.05);升高组患者FEV1/FVC、出院后90 d内急性加重复发率高于正常组(P<0.05)。(2)出院后90 d内有无急性加重复发患者性别、年龄、体质指数(BMI)、吸烟状况、糖尿病发生率、高血压发生率、FEV1/FVC、mMRC分级、CAT评分及出院后使用ICS者所占比例比较,差异无统计学意义(P>0.05);出院后90 d内有无急性加重复发患者入院前1年急性加重次数≥2次者所占比例、FEV1%pred、GOLD分级及入院时外周血EOS%比较,差异有统计学意义(P<0.05)。(3)多因素Logistic回归分析结果显示,入院时外周血EOS%≥2%是AECOPD患者出院后90 d内急性加重复发的危险因素〔OR=4.199,95%CI(1.665,10.593),P<0.05〕。�
Background Peripheral blood eosinophils percentage(EOS%)is a sensitive biomarker of eosinophilic airway inflammation,but its relation to acute exacerbation in patients with chronic obstructive pulmonary disease(COPD)is still controversial.Objective To investigate the relationship between peripheral blood EOS% at admission and recurrence of acute exacerbation shortly after discharge in patients with acute exacerbations COPD(AECOPD).Methods From July2017 to July 2018,a total of 197 AECOPD patients were selected in the Department of Respiratory Medicine,the Affiliated Hospital of Xuzhou Medical University,and they were divided into normal group(with peripheral blood EOS%<2%,n=156)and elevated group(with peripheral blood EOS%≥ 2%,n=41)according to the peripheral blood EOS% at admission.Index of pulmonary function(including(FEV1/FVC%,FEV1%pred and GOLD grades),mMRC grades,CAT score,usage of inhaled corticosteroids after discharge and recurrence rate of acute exacerbation within 90 days after discharge were compared between the two groups.General information,index of pulmonary function,mMRC grades,CAT score,peripheral blood EOS% at admission and usage of inhaled corticosteroids after discharge were compared in patients with acute exacerbation or not within 90 days after discharge;correlation between peripheral blood EOS% at admission and recurrence of acute exacerbation within 90 days after discharge in patients with AECOPD was analyzed by multivariate Logistic regression.Results(1)There was no statistically significant differences in FEV1%pred,GOLD grades,mMRC grades,CAT score or proportion of patients using inhaled corticosteroids after discharge between the two groups(P>0.05),while FEV1/FVC and recurrence rate of acute exacerbation within 90 days after discharge in elevated group were statistically significantly higher than those in normal group.(2)There was no statistically significant difference in gender,age,BMI,smoking status,incidence of diabetes or hypertension,FEV1/FVC,mMRC grades,CAT score,or proportion of
作者
王景
陈碧
朱述阳
WANG Jing;CHEN Bi;ZHU Shuyang(Department of Respiratory Medicine,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)
出处
《实用心脑肺血管病杂志》
2019年第7期46-50,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
江苏省青年医学重点人才培养项目(QNRC2016798)
关键词
慢性阻塞性肺疾病
嗜酸粒细胞
急性加重
复发
Chronic obstructive pulmonary disease
Eosinophil
Acute exacerbation
Recurrence
