慢性阻塞性肺疾病稳定期患者外周血嗜酸性粒细胞表型及临床特征分析  

Analysis of phenotype and clinical characteristics of peripheral blood eosinophil in patients with chronicobstructivepu diseaseinstablestage

作　　者：张希春[1] 刘晓芳[1] 白澎[1] 李然[1] 姚秀娟[1] 王玉红[1] Zhang Xichun;Liu Xioofang;Bui Peng;Li Ran;Yao Xiyjean;Wang Yuhong(Deprartment of Repiratory and Critical Medicine.Beijing Tongren Hospital.Capial Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院呼吸与危重症医学科,北京100730

出　　处：《临床内科杂志》2023年第7期462-465,共4页Journal of Clinical Internal Medicine

基　　金：北京市自然科学基金资助项目(7212018)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)稳定期患者外周血嗜酸性粒细胞(EOS)表型及其临床特征。方法纳入COPD稳定期患者227例,根据外周血EOS计数将其分为高EOS组(EOS计数≥300个/μl)37例、中EOS组(100个/μl≤EOS计数<300个/μl)74例及低EOS组(EOS计数<100个/μl)166例。收集所有患者一般临床资料、实验室检查结果、血气分析结果、肺功能检查结果及呼出气一氧化氮(FeNO)水平并分组进行比较。采用多元线性回归分析评估COPD稳定期患者EOS计数的相关因素。结果高EOS组年龄、近1年内COPD急性加重次数、男性及COPDC组患者比例、FeNO水平均明显高于中EOS组和低EOS组,吸烟指数明显低于中EOS组和低EOS组;高EOS组及中EOS组过去1年规律使用吸入糖皮质激素(ICS)患者比例均明显高于低EOS组,D-二聚体、纤维蛋白原水平均明显低于低EOS组(P<0.05)。多元线性回归分析结果显示,年龄、性别、吸烟指数、D-二聚体及FeNO与COPD稳定期EOS计数相关(P<0.05)。结论高EOS型COPD稳定期患者男性占比高、年龄偏大、吸烟指数低,易发生急性加重,ICS使用率高。FeNO作为反映EOS炎症水平的指标,对高EOS型COPD稳定期患者炎症水平监测具有一定意义。Objective To explore the phenotype of peripheral blood eosinophils(EOS)in patients with chronic obstructive pulmonary disease(COPD)in stable stage and its clinical characteristics.Methods A total of 227 patients with COPD in stable stage were included.According to peripheral blood EOS count,they were divided into high EOS group(EOS count≥300/μl,37 cases),medium EOS group(100/μl≤EOS count<300/μl,74 cases)and low E0S group(EOS count<100/μl,166 cases).General clinical data,laboratory test results,blood gas analysis results,lung function test results and exhaled nitric oxide(FeNO)level were collected and compared in groups.Multiple linear regression analysis was used to evaluate the factors associated with EOS count in patients with COPD in stable stage.Results In high EOS group,age,COPD acute exacerbation times in the past 1 year,proportion of patients with male and COPD C group and FeNO level were significantly higher than that in medium EOS group and low EOS group,and the smoking index were significantly lower than those in medium EOS group and low EOS group;In high EOS group and medium EOS group,the proportion of patients with regular use of inhaled corticosteroid(ICS)in the past 1 year were significantly higher than those in low EOS group,the levels of D-dimer and fibrinogen were significantly lower than those in low EOS group(P<0.05).Multiple linear regression analysis results showed that age,sex,smoking index,D-dimer and FeNO were correlated with EOS count in patients with COPD in satble stage(P<0.05).Conclusion Patients with high EOS and COPD in stable stage have a high proportion of men,older age,low smoking index,prone to acute exacerbation and high use rate of ICS.FeNO as an indicator of eosinophil inflammation has certain significance in monitoring the inflammatory level of patients with high EOS and COPD in stable stage.

关 键 词：慢性阻塞性肺疾病 嗜酸性粒细胞 表型 呼出气一氧化氮 临床特征 

分 类 号：R562.2[医药卫生—呼吸系统]