血嗜酸性粒细胞计数与冠状动脉旁路移植手术后肺炎风险（英文）  

Blood eosinophil count and risk of postoperative pneumonia following coronary artery bypass graft surgery

作　　者：谭淑芳[1] 张丽芝 黄林洁[2] 陈茗[2] 张蔚[2] 石健庭 唐恬恬 林小玲[2] TAN Shu-fang;ZHANG Li-zhi;HUANG Lin-jie;CHEN Ming;ZHANG Wei;SHI Jian-ting;TANG Tian-tian;LIN Xiao-ling(Department of Operation,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Respiratory Medicine,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院,广东广州510120 [2]中山大学孙逸仙纪念医院呼吸内科,广东广州510120

出　　处：《中国病理生理杂志》2018年第8期1383-1389,共7页Chinese Journal of Pathophysiology

基　　金：Supported by the Natural Science Foundation of Guangdong Province(No.2017A030313822)

摘　　要：目的:研究血嗜酸性粒细胞计数与冠状动脉旁路移植手术患者术后肺炎风险的关系。方法:收集2008年~2017年在我院进行冠状动脉旁路移植手术的613例患者资料进行分析,比较不同血嗜酸性粒细胞计数患者术后肺炎发生率及住院死亡率,采用多因素回归分析明确患者术后肺炎的危险因素。结果:研究共纳入582例患者,其中220例患者血嗜酸性粒细胞比例<2%(低血嗜酸性粒细胞组),362例患者血嗜酸性粒细胞比例≥2%(高血嗜酸性粒细胞组)。低血嗜酸性粒细胞组术后肺炎发生率(14.1%,31/220)明显高于高血嗜酸性粒细胞组(6.4%,23/362,P=0.002),而2组患者住院死亡率无明显差异。多因素回归分析结果显示低血嗜酸性粒细胞计数(OR=3.521,95%CI:1.213~10.223,P=0.021)、鼻胃管(OR=6.490,95%CI:2.757~15.280,P<0.001)和机械通气时间≥24 h(OR=3.496,95%CI:1.156~10.178,P=0.035)为术后发生肺炎的独立危险因素。结论:低血嗜酸性粒细胞计数患者冠状动脉旁路移植手术后发生肺炎的风险升高。AIM： To investigate the relationship between blood eosinophil count and risk of postoperative pneumonia in patients with coronary artery bypass graft（ CABG） surgery. METHODS： The medical records of 613 patients who underwent CABG surgery from January 2008 to December 2017 in our hospital were collected and reviewed. The incidence of postoperative pneumonia and hospital mortality were compared in the patients with low or high blood eosinophil count. The risk factors for postoperative pneumonia following CABG surgery were analyzed by multiple logistic regression. RESULTS：The patients enrolled in the study were 582,in which 220 patients had preoperative blood eosinophil counts of less than 2%（ low blood eosinophil count） and 362 patients had eosinophil counts of 2% or more（ high blood eosinophil count）. The incidence of postoperative pneumonia in the patients with low blood eosinophil count was 14. 1%（ 31/220）,significantly higher than that（ 6. 4%,23/362） in the patients with high blood eosinophil count（ P = 0. 002）. However,the hospital mortality of the patients with high or low blood eosinophil count had no difference. Low blood eosinophil count（ OR = 3. 521,95% CI： 1. 213 ～ 10. 223,P = 0. 021）,nasogastric tube（ OR = 6. 490,95% CI： 2. 757 ～ 15. 280,P〈0. 001） and mechanical ventilation ≥24 h（ OR = 3. 496,95% CI： 1. 156 ～ 10. 178,P = 0. 035） were identified as independent risk factors for postoperative pneumonia following CABG surgery. CONCLUSION： Low blood eosinophil count is associated with increased risk of postoperative pneumonia following CABG surgery.

关 键 词：嗜酸性粒细胞 肺炎 危险因素 冠状动脉旁路移植术 

分 类 号：R563.1[医药卫生—呼吸系统] R363[医药卫生—内科学]