痰和血清嗜酸性粒细胞表达水平与COPD患者病情及预后的关系探讨  

Exploration of the Relationship between the Expression of Levels of Eosinophils in Sputum and Serum and the Condition and Prognosis of COPD Patients

作　　者：刘丽荣 胡家沅 LIU Lirong;HU Jiayuan(Department of Respiratory and Critical Care Medicine,Ruijin People's Hospital,Ruijin 342500,China;不详)

机构地区：[1]瑞金市人民医院呼吸与危重症医学科,江西瑞金342500

出　　处：《中国医学创新》2024年第12期130-134,共5页Medical Innovation of China

摘　　要：目的:探究痰嗜酸性粒细胞(EOS)、血清EOS表达水平与慢性阻塞性肺疾病(COPD)患者病情及预后的关系。方法:选取2020年6月—2022年6月瑞金市人民医院呼吸与危重症医学科收治的62例COPD患者作为病例组,依据不同疾病进展将病例组患者再次分为急性加重期组(30例)和稳定期组(32例),依据预后情况将病例组患者分为死亡组(12例)和生存组(50例),另选取同期来本院体检的健康者30例作为对照组,比较各组痰EOS、血清EOS表达水平,分析上述指标与COPD严重程度的关系。结果:在痰EOS、血清EOS表达水平比较上,急性加重期组>稳定期组>对照组(P<0.05)。病例组GOLD分级Ⅲ+Ⅳ级患者痰EOS、血清EOS表达水平均高于Ⅰ+Ⅱ级患者(P<0.05)。病例组死亡患者痰EOS、血清EOS表达水平均高于生存患者(P<0.05)。痰EOS的cut off值为19.55×10^(5)/mL时,其诊断COPD患者预后的敏感度、特异度、AUC分别为83.33%、76.00%、0.850[95%CI(0.737,0.928)];血清EOS的cut off值为276.23×10^(5)/mL时,其诊断COPD患者预后的敏感度、特异度、AUC分别为75.00%、62.00%、0.747[95%CI(0.620,0.849)]。结论:痰EOS、血清EOS表达水平可反映COPD的病情进展情况,可用于临床COPD患者的预后评估。Objective:To explore the relationship between the expression of sputum eosinophils(EOS)and serum EOS expression levels and the condition and prognosis of patients with chronic obstructive pulmonary disease(COPD).Method:A total of 62 patients with COPD admitted to Department of Respiratory and Critical Care Medicine,Ruijin People's Hospital from June 2020 to June 2022 were selected as the case group.The patients in the case group were again divided into acute exacerbation group(30 cases)and stable stage group(32 cases)according to the progress of the disease.The patients in the case group were divided into death group(12 cases)and survival group(50 cases)according to the prognosis.In addition,30 healthy people who came to our hospital for physical examination at the same time were selected as the control group,and the expression levels of EOS in sputum and serum in each group were compared,the relationship between the above indicators and the severity of COPD were analyzed.Result:In terms of the expression levels of sputum EOS and serum EOS,the acute exacerbation group>stable stage group>control group(P<0.05).The expression levels of EOS in sputum and serum of patients with GOLD grade Ⅲ+Ⅳ in the case group were higher than those of patients with GOLD grade Ⅰ+Ⅱ(P<0.05).The expression levels of EOS in sputum and serum of the deceased patients in the case group were higher than those of the surviving patients(P<0.05).The cut off value of sputum EOS was 19.55×10^(5)/mL,its sensitivity,specificity and AUC for diagnosis of COPD were 83.33%,76.00% and 0.850[95%CI(0.737,0.928)];the cut off value of serum EOS was 276.23×10^(5)/mL,its sensitivity,specificity and AUC for diagnosis of COPD were 75.00%,62.00% and 0.747[95%CI(0.620,0.849)].Conclusion:The expression of EOS in sputum and serum can reflect the progress of COPD and can be used in the prognosis evaluation of clinical COPD patients.

关 键 词：慢性阻塞性肺疾病 诱导痰 嗜酸性粒细胞 血清 

分 类 号：R563.9[医药卫生—呼吸系统]