外周血嗜酸细胞增多与慢阻肺住院患者临床特征及住院转归的相关性  

Correlation of increased blood eosinophil count with clinical characteristics and prognosis of inpatients with chronic obstructive pulmonary disease

作　　者：张颖 王晓晟[1] 买智涛[1] 姜明明[1] 万善志 ZHANG Ying;WANG Xiao-sheng;MAI Zhi-tao;JIANG Ming-ming;WAN Shan-zhi(Department of Respiratory and Critical Care Medicine,Cangzhou Central Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市中心医院呼吸与危重症医学科

出　　处：《临床肺科杂志》2020年第3期368-372,共5页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析血嗜酸细胞计数增多与慢阻肺急性加重住院患者临床特征及住院转归的关系。方法分析2015年1月至2016年12月于沧州市中心医院因慢阻肺急性加重住院患者的临床资料。分别以嗜酸细胞计数2%和3%为界值,≥2%和≥3%定义为高嗜酸组,<2%和<3%定义为低嗜酸组作为标准,比较两组人口统计学特征、临床特点、血化验检查、合并症、治疗以及住院时间、转归的差异。结果共纳入慢阻肺住院患者566例。以2%和3%作为界值,高嗜酸组住院患者分别为196例(34.6%)和128例(22.6%)。无论按照2%还是3%定义标准,高嗜酸组白细胞计数、中性粒细胞计数均低于低嗜酸组,淋巴细胞计数均高于低嗜酸组;合并心力衰竭比例低于低嗜酸组;抗生素联合比例、静脉激素使用比例以及应用总量、无创机械通气比例均低于低嗜酸组。此外,按照2%定义标准,高嗜酸组发病时间、住院天数、高血压病比例、静脉激素应用天数、入住呼吸重症监护室比例、住院死亡率均低于低嗜酸组;白蛋白浓度高于低嗜酸组。而按照3%定义标准,均无显著差异。结论高嗜酸细胞计数患者具有独特的临床特征和较好的临床转归,提示血嗜酸细胞计数可能作为一种判断慢阻肺转归的临床生物标志物。Objective To explore the relationship of increased blood eosinophil cell count with clinical characteristics and prognosis of inpatients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of patients with AECOPD at Cangzhou central hospital from January 2015 to December 2016 were retrospectively analyzed.The COPD patients were defined as the high eosinophil group and low eosinophil group with 2%and 3%used as the cutoff values.The differences in demographic,clinical characteristic,blood test,complications,treatment,length of hospitalization and prognosis were compared between the two groups.Results 566 patients with AECOPD were enrolled in this study.The patients with high eosinophil count were 196 cases(34.6%)and 128 cases(22.6%),with 2%and 3%as the cutoff values,respectively.Whether 2%or 3%was used as the cutoff value,the high eosinophil group tended to have lower leucocyte and neutrophils count,higher lymphocytes,less heart failure,lower proportion of dual antibiotics treatment,lower proportion of intravenous corticosteroids and the total dose of lower intravenous corticosteroids treatment and lower non-invasive ventilator than the low eosinophil group did.According to 2%as the cutoff value,the high eosinophil group tended to have shorter onset of symptom and duration of hospital stay,less hypertension,shorter days of intravenous corticosteroids treatment,lower proportion of respiratory in tensive cave unit(RICU),lower mortolity and higher albumin than the low eosinophil group did.However,when 3%was used as the cutoff value,there was no significant difference in above mentioned indicators between the two groups.Conclusion The patients with high eosinophil counts have unique clinical characteristics and better clinical outcome,suggesting that blood eosinophil count may be used as a clinical biomarker to judge the prognosis of COPD.

关 键 词：血嗜酸细胞 慢性阻塞性肺疾病 转归 

分 类 号：R563.9[医药卫生—呼吸系统]