不同水平血嗜酸性粒细胞的慢性阻塞性肺疾病急性加重期患者临床特征及预后比较  

Clinical characteristics and prognosis of AECOPD patients with different eosinophil levels

作　　者：魏东晖 李津娜[1] 周宁[1] 王乐[1] 张静[1] 曹洁[1] WEI Donghui;LI Jinna;ZHOU Ning;WANG Le;ZHANG Jing;CAO Jie(Department of Respiratory and Critical Care,Tianjin Medical University General Hospital,Tianjin 300000,China)

机构地区：[1]天津医科大学总医院呼吸与危重症医学科,天津300000

出　　处：《实用医学杂志》2022年第16期2037-2041,共5页The Journal of Practical Medicine

基　　金：国家民政部基金资助项目(编号:BJ-RW2020014J)。

摘　　要：目的分析不同水平血嗜酸性粒细胞的慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期患者临床表现、激素治疗反应性并随访其预后。方法收集2020年1-12月在天津医科大学总医院呼吸与危重症学科住院的124例COPD患者,以入院24 h内血嗜酸粒细胞绝对值计数为基线水平将患者分为3组,组Ⅰ为低EOS组(EOS#<100细胞/μL)(52例),组Ⅱ为中EOS组(100细胞/μL≤EOS#≤300细胞/μL)(51例),组Ⅲ为高EOS组(EOS#>300细胞/μL)(21例),并分析相关数据。结果低水平血嗜酸性粒细胞(EOS#<100/μL)患者病情更危重;中、高水平血嗜酸性粒细胞(EOS#≥100/μL)患者对糖皮质激素应答好,长期ICS治疗可减少EOS#>300细胞/μL患者再发重度急性加重风险。结论血嗜酸性粒细胞对评价慢阻肺急性加重期患者的病情严重程度、ICS获益及临床预后有重要的参考价值。Objective To analyze the clinical characteristics,laboratory examination indicators,glucocorticoid therapy responsiveness of hospitalized patients with AECOPD with different blood eosinophil levels and to follow up for the prognosis.Methods A total of 124 COPD patients hospitalized in the Department of Respiratory and Critical Care Medicine,General Hospital of Tianjin Medical University from January 1 to December 31,2020,were concluded.The patients were divided into 3 groups according to the absolute value of blood eosinophil count within 24 hours of admission as the baseline level;the relevant data were analyzed and the curve was drawn.Results Blood eosinophil levels could assess the severity of disease progression in patients with AECOPD.Patients with EOS less than 100 cells/μL were more critically ill,but those with EOS greater than or equal to 100 cells/μL responded well to glucocorticoids,and long-term ICS treatment can reduce the risk of recurrent severe exacerbations in patients with EOS greater than 300 cells/μL.Conclusion The level of blood eosinophils helps to assess the degree of deterioration,benefit from ICS,and prognosis in AECOPD patients.

关 键 词：嗜酸性粒细胞 慢性阻塞性肺疾病急性加重期 糖皮质激素 临床特征 预后 

分 类 号：R56[医药卫生—呼吸系统]