嗜酸性粒细胞增多表型慢性阻塞性肺疾病患者的临床特征及预后分析

Clinical features and prognosis analysis of chronic obstructive pulmonary disease patients with blood eosinophilia phenotype

摘要:

目的 探讨伴有外周血嗜酸性粒细胞增多的慢性阻塞性肺疾病急性加重（AECOPD）患者临床特征及治疗后的症状缓解情况。方法 选取2016年10月—2018年7月南京医科大学附属苏州科技城医院AECOPD加重患者140例。根据入组时外周血嗜酸性粒细胞百分比（B-Eos）分为两组。A组为B-Eos≥2%的患者，B组为B-Eos<2%的患者。入组时收集相关资料，对AECOPD患者予以相应治疗，随访治疗后的1周、 1、3及6个月的英国医学研究委员会呼吸困难量表（mMRC）评分及1年内急性加重次数，比较两组治疗后mMRC评分和急性发作变化。结果 140例患者经1年随访共98例患者完成本项研究。这些患者中基线B-Eos≥2%的患者占45.1%。两组患者治疗后6个月的mMRC评分整体分析差异无统计学意义（P?>0.05），但在时间点、分组与时点间交互作用上差异有统计学意义（P?<0.05）。组间比较示在1周、1个月这2个时间点mMRC评分差异有统计学意义（P?<0.05）。随访1年后两组患者再住院率分别为41.6%和64.0%，差异有统计学意义（P?<0.05）。结论 B-Eos≥2%的AECOPD患者经治疗后mMRC评分下降较快。表明外周血嗜酸性粒细胞水平能预测AECOPD患者短期内的疗效。

Abstract:

Objective To investigate the clinical features and symptom relief of AECOPD patients with peripheral blood eosinophilia. Methods Totally 140 COPD patients with AECOPD who visited the Affiliated Suzhou Hospital of Nanjing Medical University from October 2016 to July 2018 were recruited into this study. According to the rates of peripheral blood eosinophil, patients were divided into two groups. Eosinophilic group (A) is peripheral blood eosinophil ≥ 2% of total leukocyte count and the others is in non-eosinophilic group (B). Clinical data was collected at admission. According to the guidelines, every patient was treated. The mMRC scores were collected at 1st week, 1 mounth, 3 mounth, 6 mounth after treatment and readmission rates were collected within one year after treatment. Admission details and mMRC scores were compared between two groups. Results A total of 140 AECOPD patients with acute exacerbations were recruited. After about 12 months’ follow-up, a total of 98 subjects have completed this study. 45.1% of subjects met our criteria for peripheral blood eosinophil ≥ 2% of total leukocyte count. There was no significant difference in mMRC scores between the two groups after treatment (P?> 0.05). But time point, the interactions between grouping and time point were significant (P?