嗜酸性粒细胞减少在新型冠状病毒肺炎患者中的临床意义  

Clinical significance of eosinopenia in patients with coronavirus disease 2019

作　　者：程玉生[1] 周云 朱孟德[3] 杨江华[4] 陆志伟[1] CHENG Yusheng;ZHOU Yun;ZHU Mengde;YANG Jianghua;LU Zhiwei(Department of Respiratory and Critical Care Medicine,Yijishan Hospital o/Warman Medical College,Wuhu,Anhui 241001,P.R.China;Department of Respiratory and Critical Care Medicine,Second People's Hospital ofWuhu,Wuhu,Anhui 241000,P.R.China;Department of Respiratory and Critical Care Medicine,First People's Hospital of Hefei,Hefei,Anhui 230061,P.R.China;Department of Infectious Diseases,Yijishan Hospital ofWannan Medical College,Wuhu,Anhui 241001,P.R.China)

机构地区：[1]皖南医学院弋矶山医院呼吸与危重症医学科,安徽芜湖241001 [2]芜湖市第二人民医院呼吸与危重症医学科,安徽芜湖241000 [3]合肥市第一人民医院呼吸内科,安徽合肥230061 [4]皖南医学院弋矶山医院感染性疾病科,安徽芜湖241001

出　　处：《中国呼吸与危重监护杂志》2021年第5期315-319,共5页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：安徽省高等学校自然科学基金重点项目(KJ2017A264);芜湖市新型冠状病毒肺炎防控科技重点项目(2020dx1-1、2020dx1-3、2020dx2-1)。

摘　　要：目的探讨嗜酸性粒细胞减少在新型冠状病毒肺炎(简称新冠肺炎)患者中的临床意义。方法回顾性分析于2020年1月23日至2020年3月10日期间在安徽省三所医院收治的新冠肺炎患者临床资料及诊治经过。结果共收集59例新冠肺炎患者临床资料,男性患者32例,中位年龄为39岁。出现嗜酸性粒细胞减少患者共30例。与非嗜酸性粒细胞减少组相比,嗜酸性粒细胞减少组患者咳嗽、咳痰和乏力等症状更为常见,具有显著性统计学差异。嗜酸性粒细胞减少组的淋巴细胞计数(中位数101个/μL)显著低于非嗜酸性粒细胞减少组(中位数167个/μL,P<0.001)。嗜酸性粒细胞减少组接受糖皮质激素治疗的比例显著高于非嗜酸性粒细胞减少组(50.0%比13.8%,P=0.005)。多因素分析示淋巴细胞计数降低是嗜酸性粒细胞减少发生的独立危险因素(比值比6.566,95%可信区间1.101~39.173,P=0.039)。结论嗜酸性粒细胞减少在新冠肺炎患者中较为常见,其患者具有不同的临床特征。淋巴细胞计数降低可能是导致新冠肺炎患者嗜酸性粒细胞减少发生的重要危险因素。Objective To describe clinical significance of eosinopenia in patients with coronavirus disease 2019(COVID-19). Methods This was a retrospective study conducted in three tertiary hospitals from Anhui province, China.A total of 59 patients with COVID-19 were consecutively reviewed from January 23, 2020 to March 10, 2020. Results The median age of patients with COVID-19 was 39 years old, and 32 were male, 30 with eosinopenia. Cough, sputum and fatigue were more common symptoms in eosinopenia patients compared with non-eosinopenia patients. The counts of blood lymphocytes(median: 101 cells/μL) in eosinopenia patients were significantly less than those of non-eosinopenia patients(median: 167 cells/μL, P<0.001). COVID-19 patients with eosinopenia had a higher proportion of corticosteroids therapy than patients with non-eosinopenia(50.0% vs. 13.8%, respectively, P=0.005). Decreased blood lymphocytes count was an independent risk factor for eosinopenia in COVID-19 patients(odds ratio 6.566, 95%CI 1.101-39.173, P=0.039).Conclusions Blood eosinopenia is frequent in COVID-19 patients. Patients with eosinopenia have different clinical features compared to patients with non-eosinopenia. Decreased lymphocyte count is an independent risk factor for eosinopenia in COVID-19 patients.

关 键 词：新型冠状病毒肺炎 嗜酸性粒细胞 淋巴细胞 

分 类 号：R563.1[医药卫生—呼吸系统]