外周血嗜酸性粒细胞与哮喘-慢性阻塞性肺气肿重叠急性加重风险的相关研究*

Clinical significance of peripheral blood eosinophils on acute exacerbation in patients with asthma-COPD overlap*

摘要:

目的 探讨外周血嗜酸性粒细胞（EOS）水平与哮喘-慢性阻塞性肺疾病重叠（ACO）患者急性加重风险的关系。方法 回顾性分析2016年12月—2018年5月河南省人民医院呼吸与危重症学科住院的ACO患者52例，依据外周血EOS百分率将其分为两组：升高组（EOS百分率>2%）22例；正常组（EOS百分率≤2%）30例，对两组患者的基线资料、肺功能、血常规、C反应蛋白（CRP）、诱导痰EOS百分率、住院时间、急性加重频次及间隔时间进行比较。结果 升高组患者的外周血EOS计数、白细胞计数、CRP水平及诱导痰EOS百分率较正常组均高（P?<0.05）；升高组患者的第1秒钟用力呼气容积占用力肺活量比值（FEV1/FVC）、第1秒钟用力呼气容积占预计值的百分比（FEV1%）较正常组均降低（P?<0.05）；与正常组比较，升高组患者的急性加重次数增多（P?<0.05），急性加重的间隔时间缩短（P?<0.05），住院时间延长（P?< 0.05）；外周血EOS百分率与急性加重频次呈正相关（r?=0.706，P?=0.000），与急性加重的间隔时间呈负相关（r?= -0.636，P?=0.000）；外周血EOS计数与急性加重频次呈正相关（r?=0.690，P?=0.000），与急性加重的间隔时间呈负相关（r?=-0.599，P?=0.000）。结论 外周血EOS水平与ACO患者急性加重的风险有关，外周血EOS水平增高提示ACO患者急性加重的风险可能增加。

Abstract:

Objective To investigate the relationship between the level of eosinophils (EOS) in peripheral blood and the risk of acute exacerbation in patients with asthma-COPD overlap (ACO). Methods A total of 52 in-patients with ACO admitted in the Henan Provincial People’s Hospital during December 2016 to September 2018 were retrospectively collected and analyzed. They were divided into two groups according to peripheral blood eosinophilic percentage (EOS%): elevated eosinophil group (EOS% > 2%, n?=?22), and normal eosinophil group (EOS% ≤ 2%, n?=?30). The baseline data, lung function, blood routine, C-reactive protein levels (CRP), induced sputum eosinophilic percentage, duration of hospital stay, frequency and interval time of acute exacerbation were recorded. Results The eosinophil count, leukocyte count, CRP in peripheral blood and induced sputum eosinophilic percentage in elevated group were higher significantly than those in normal group (P?