外周血嗜酸性粒细胞与高龄慢性阻塞性肺病急性加重期患者病情程度、亚型的关系研究

Study of the relationship between peripheral blood eosinophils and severity and subtypes of acute exacerbation of chronicobstructive pulmonary disease in elderly patients

目的 分析外周血嗜酸性粒细胞(EOS)与高龄(≥80岁)慢性阻塞性肺病急性加重期(AECOPD)患者病情、亚型的关系。方法 选取2016年10月-2022年10月西部战区总医院235例高龄AECOPD患者为观察对象(设为AECOPD组),并取同期199例体检健康高龄老人为对照组。比较2组临床资料;并根据AECOPD患者外周血EOS%值分为≥2%增高亚组与<2%非增高亚组,比较2亚组的临床资料,分析EOS%与AECOPD临床分级、呼吸困难量表(mMRC)评分及细菌与病毒亚型的相关性。结果 AECOPD组与对照组吸烟史、EOS%、 EOS计数、 BASO计数、 WBC、单核细胞计数、 LY、 NEUT及NE%检测值比较,差异均有统计学意义(P<0.05);≥2%增高亚组男性、有吸烟史、 AECOPD临床分级Ⅰ级及病毒型占比、 EOS%、 EOS计数、 BASO计数、 LY检测值均显著高于<2%非增高亚组(P<0.05),而WBC、单核细胞计数、 NEUT、 NE%检测值及mMRC评分均显著低于<2%非增高亚组(P<0.05);外周血EOS%与AECOPD临床分级、 mMRC评分呈负相关性(P<0.05),与病毒型呈正相关性(P<0.05)。结论 外周血EOS与高龄AECOPD患者疾病严重程度及亚型密切相关,病情严重或病毒型感染为EOS%值增高的主要原因。

Objective To analyze the relationship between peripheral blood eosinophils(EOS)and disease severity and subtypes of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)in elderly patients(≥80 years old).Methods 235 elderly patients(≥80 years old)with AECOPD treated in General Hospital of Western Theater Command from October 2016 to October 2022 were selected as the observation subjects(AECOPD group).Another 199 healthy elderly people who underwent physical examination during the same period were selected as the control group.The clinical data of the two groups were compared.According to peripheral blood EOS%value of AECOPD patients,the patients were divided into≥2%increased subgroup and<2%non⁃increased subgroup.The clinical data of the two subgroups were compared.The correlation of EOS%with AECOPD clinical grade,dyspnea scale(mMRC)score and bacterial subtype and viral subtype was analyzed.Results There were statistically significant differences in smoking history,EOS%,EOS count,BASO count,WBC,mono⁃cyte count,LY,NEUT and NE%between the AECOPD group and the control group(P<0.05).The proportion of male,smoking history,AECOPD clinical gradeⅠand viral type,EOS%,EOS count,BASO count and LY value in the≥2%increased subgroup were significantly higher than those in the<2%non⁃increased subgroup(P<0.05),while WBC,monocyte count,NEUT,NE%and mMRC scores were significantly lower than those in the<2%non⁃increased subgroup(P<0.05).Periph⁃eral blood EOS%was negatively correlated with the clinical grade of AECOPD and mMRC score(P<0.05),but positively correlated with virus type(P<0.05).Conclusion Peripheral blood EOS is closely related to the severity and subtypes of dis⁃ease in elderly AECOPD patients,with severe illness or viral infection being the main cause of increased EOS%.