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

The Clinical Value of Peripheral Blood Eosinophils in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

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。

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.