外周血嗜酸性粒细胞对慢性阻塞性肺疾病急性加重激素治疗相关性分析

Correlation between Peripheral Blood Eosinophils and Hormone Therapy of Patients with AECOPD

目的分析外周血嗜酸性粒细胞(eosimophil,EOS)与慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者静脉应用糖皮质激素的相关性。方法选取AECOPD患者83例,分为观察组(EOS%≥2%)25例与对照组(EOS%<2%)58例。比较2组外周血EOS、EOS百分比(EOS%)、白细胞(WBC)、中性粒细胞(N)、中性粒细胞百分比(N%)、C-反应蛋白(CRP)等指标水平,采用受试者工作特征曲线(ROC曲线)评价EOS、EOS%对AECOPD患者静脉糖皮质激素应用的预测价值。结果观察组患者EOS、EOS%分别为(0.50±0.07)×109/L、(3.01±0.95)%,高于对照组的(0.20±0.09)×109/L、(1.67±0.23)%,差异有统计学意义(P<0.05)。观察组患者的WBC、N、N%、CRP、静脉激素应用时间等指标分别为(6.83±2.06)×109/L、(4.36±1.81)×109/L、(62.03±10.56)%、(8.95±2.76)mg/L及(0.48±0.07)d,小于对照组的(8.68±3.89)×109/L、(6.94±2.05)×109/L、(76.71±12.44)%、(11.45±3.90)mg/L及(2.03±0.92)d,差异均有统计学意义(P<0.05)。经ROC曲线分析,EOS%的AUC较大,为0.732(95%CI:0.621~0.844),其对应灵敏度和特异度分别为40.7%和83.0%。结论外周血EOS对于AECOPD患者的炎症评估及指导糖皮质激素抗感染治疗具有一定的临床价值。

Objective to analyze the correlation between the peripheral blood eosinophil(EOS)and intravenous glucocorticoid administration in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A total of 83 patients with acute exacerbation of copd were selected and divided into observation group(EOS%≥2%)with 25 patients and control group(EOS<2%)with 58 patients.The level of EOS,EOS%,leukocyte(W),neutrophil(N),neutrophil percentage(N%)and C-reactive protein(CRP)were compared in each group.ROC curve was used to evaluate the predictive value of EOS and EOS%in intravenous glucocotricoid used in patients with AECOPD.Results The percentage of EOS and EOS%in observation group were(0.50±0.07)×109/L,(3.01±0.95)%,which were higher than those in control group(0.20±0.09)×109/L,(1.67±0.23)%,the difference is statistically significant(P<0.05).The indexes of W,N,N%,CPR and intravenous hormone application time in group observation were(6.83±2.06)×109/L,(4.36±1.81)×109/L,(62.03±10.56)%,(8.95±2.76)mg/L,(0.48±0.07)d respectively,and it was smaller than those in control group:(8.68±3.89)×109/L,(6.94±2.05)×109/L,(76.71±12.44)%,(11.45±3.90)mg/L,(2.03±0.92)d respectively,the difference is statistically significant(P﹤0.05).According to the analysis of ROC curve,the receiver characteristic curve AUC of EOS%is larger,0.732(95%CI:0.621~0.844),and its corresponding sensitivity and specificity are 40.7%and 83%respectively.ConclusionPeripheral blood eosinophils have a certain clinical value in the evaluation of inflammation and anti-inflammation therapy of glucocorticoid in patients with AECOPD.