慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞的临床应用价值  

Clinical value of blood eosinophils in acute exacerbation of chronic obstructive pulmonary disease

作　　者：张雪[1] 荣光生 钱晓君[1] 魏雪 朱代峰[1] 严玉玲[1] ZHANG Xue;RONG Guangsheng;QIAN Xiaojun;WEI Xue;ZHU Daifeng;YAN Yuling(Department of Respiratory Medicine,The Third People's Hospital of Hefei(The Third Clinical College of Hefei Affiliated to Anhui Medical University),Hefei,Anhui 230022,China)

机构地区：[1]合肥市第三人民医院(安徽医科大学合肥第三临床学院)呼吸内科,安徽合肥230022

出　　处：《安徽医药》2021年第7期1392-1395,共4页Anhui Medical and Pharmaceutical Journal

基　　金：合肥市卫生计生委2016应用医学项目(hwk2016yb008)。

摘　　要：目的分析不同水平血嗜酸性粒细胞(EOS)在慢性阻塞性肺疾病急性加重期(AECOPD)的临床特点,探讨血EOS的临床应用价值。方法选取2018年1月1日至2019年5月31日合肥市第三人民医院住院诊断AECOPD的197例病人,以入院血常规中EOS百分比(EOS%)分为两组,EOS%<2%为阴性组(138例),EOS%≥2%为阳性组(59例)。对比分析两组病人临床特征、实验室检查结果、住院时间及糖皮质激素治疗反应性。结果阳性组病人慢阻肺评估测试(CAT)分值、改良英国研究理事会呼吸困难指数(mMRC)分值、C-反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)水平低于阴性组,慢性阻塞性肺疾病全球倡议(GOLD)Ⅱ级分布率40.7%(24/59)高于阴性组14.5%(20/138),住院时间10.9(5~38)d短于阴性组13.6(5~45)d(P=0.047),糖皮质激素用量(181±200)mg少于阴性组(351±301)mg(P<0.001),治疗第7天CAT分值较入院当天改善(△CAT)≥2者占96.6%(57/59),高于阴性组80.4%(111/138)(P=0.003)。使用糖皮质激素治疗的病人阳性组△CAT≥2者占95.9%(47/49),高于阴性组80.6%(104/129)(P=0.011)。结论在慢性阻塞性肺疾病急性加重期血EOS水平对预测细菌感染水平、糖皮质激素的治疗反应具有参考价值。Objective To analyze the clinical characteristics of blood eosinophils(EOS)at different levels in acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to explore the clinical application value of eosinophils.Methods 197 hospitalized patients diagnosed as AECOPD in the Third People’s Hospital of Hefei from January 1,2018 to May 31,2019 were selected.They were divided into two groups according to EOS%in blood routine,with EOS%less than 2%as negative group(138 cases),and EOS%more than 2%as positive group(59 cases).We retrospectively analyzed the clinical characteristics,laboratory examination results,hospitalization time and glucocorticoid therapy responsiveness.Results assessment test(CAT),modified British Medical Research Council(mMRC),C-reactive protein(CRP)and neutrophil-to-lymphocyte ratio(NLR)in the positive group were lower than those in the negative group.In the positive group,the gradeⅡdistribution rate of global initiative for chronic obstructive lung disease(GOLD)was 40.7%(24/59),which was higher than 14.5%(20/138)in the negative group.Hospitalization days in the positive group was 10.9(5-38)days,which was shorter than 13.6(5/45)days in the negative group(P=0.047).The level of glucocorticoids in the positive group is(181±200)mg,less than(351±301)mg in the negative group(P<0.001).In the positive group,patients with the CAT score on the 7 th day of treatment better than that on the day of admission(△CAT)≥2 accounted for 96.6%(57/59),which was higher than 80.4%(111/138)in the negative group(P=0.003).The patients with△CAT≥2 after glucocorticoids treatment in the positive group accounted for 95.9%(47/49),which was higher than 80.6%(104/129)in the negative group(P=0.011).Conclusion corticosteroids therapy.

关 键 词：肺疾病 慢性阻塞性 嗜酸性粒细胞 呼吸困难 C反应蛋白 糖皮质激素类 急性加重 

分 类 号：R563.9[医药卫生—呼吸系统]