慢阻肺患者外周血EOS与FeNO水平及肺功能的相关性分析

Correlations between EOS and FeNO levels and lung function in COPD patients

目的对慢性阻塞性肺疾病(慢阻肺)患者外周血嗜酸性粒细胞(EOS)与呼出气一氧化氮(FeNO)水平及肺功能的相关性进行分析。方法选取2019年10月至2023年6月徐州市第一人民医院收治的200例慢阻肺患者作为研究对象,并设为观察组。其中男138例,女62例;年龄55~88(66.45±5.45)岁;病程1~18(10.23±3.23)年。根据疾病分期,将观察组患者分为急性发作组(150例)和稳定期组(50例)。另选取同期住院的100例非慢阻肺患者作为对照组。收集300例受试者的一般资料,如吸烟史、饮酒史、基础疾病及体重指数(BMI)等。采用全自动血细胞分析仪检测EOS水平,采用FeNO检测仪检测FeNO水平,采用肺功能检测仪检测肺功能。采用Pearson相关分析法分析慢阻肺患者外周血EOS与FeNO水平及肺功能的相关性。采用独立样本t检验、F检验和χ^(2)检验。结果观察组吸烟史人数占比[52.50%(105/200)]高于对照组[17.00%(17/100)](P<0.05)。稳定期组和急性发作组外周血EOS[(6.23±0.21)%、(6.42±0.58)%]与FeNO[(35.52±7.28)ppb、(46.28±7.08)ppb]水平均高于对照组[(2.23±0.59)%、(15.23±7.34)ppb],且急性发作组FeNO水平高于稳定期组(均P<0.05)。稳定期组和急性发作组用力肺活量(FVC)[(2.18±0.18)L、(2.16±0.15)L]、第1秒用力呼气容积(FEV1)[(1.16±0.31)L、(1.14±0.28)L]、FEV1/FVC[(60.56±8.24)%、(59.23±8.21)%]及FEV1%[(65.23±8.59)%、(64.11±8.12)%]均低于对照组[(3.16±0.38)L、(2.21±0.41)L、(82.28±9.16)%、(89.62±5.23)%](均P<0.05)。Pearson相关性分析显示,慢阻肺患者外周血EOS水平与FeNO水平呈正相关(r=0.584,P=0.002),与FEV1/FVC呈负相关(r=-0.213,P=0.005)。结论慢阻肺患者外周血EOS与FeNO水平及肺功能存在明显相关性,临床可根据其水平变化来判断患者病情,并为后期治疗提供一定的指导。

Objective To analyze the correlations between blood eosinophils(EOS)and fractional concentration of exhaled nitric oxide(FeNO)levels and lung function in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 200 patients with COPD treated in Xuzhou First People's Hospital from October 2019 to June 2023 were selected as the study objects and were set as the observation group.Among them,there were 138 males and 62 females,aged 55-88(66.45±5.45)years,and the course of disease was 1-18(10.23±3.23)years.According to the disease stage,the observation group was divided into an acute attack group(150 cases)and a stable stage group(50 cases).Another 100 patients with non-COPD who were hospitalized during the same period were selected as the control group.The general data,such as smoking history,drinking history,underlying diseases,and body mass index(BMI),were collected from the 300 subjects.The EOS level was detected by automatic blood cell analyzer,the FeNO level was detected by FeNO detector,and the lung function was detected by lung function detector.The correlations between EOS and FeNO levels in peripheral blood and lung function of COPD patients were analyzed by Pearson correlation analysis.Independent sample t test,F test,andχ^(2)test were used.Results The proportion of smoking history in the observation group[52.50%(105/200)]was higher than that in the control group[17.00%(17/100)](P<0.05).The levels of EOS[(6.23±0.21)%,(6.42±0.58)%]and FeNO[(35.52±7.28)ppb,(46.28±7.08)ppb]in peripheral blood of the stable stage and acute attack groups were higher than those of the control group[(2.23±0.59)%,(15.23±7.34)ppb],and the FeNO level in the acute attack group was higher than that in the stable stage group(all P<0.05).The forced vital capacity(FVC)[(2.18±0.18)L,(2.16±0.15)L],forced expiratory volume in the first second(FEV1)[(1.16±0.31)L,(1.14±0.28)L],FEV1/FVC[(60.56±8.24)%,(59.23±8.21)%],and FEV1%[(65.23±8.59)%,(64.11±8.12)%]in the stable stage and acute attack groups were lower than those in the control group[(3.16±0.38)L,(2.21±0.41)L,(82.28±9.16)%,and(89.62±5.23)%](all P<0.05).Pearson correlation analysis showed that the EOS level in peripheral blood of COPD patients was positively correlated with FeNO level(r=0.584,P=0.002),and negatively correlated with FEV1/FVC(r=-0.213,P=0.005).Conclusions There is a significant correlation between EOS%and FeNO level as well as lung function in COPD patients.Clinically,changes in their levels can be used to assess the patients'condition and provide guidance for later treatment.