痰液中ECP和IL-8对不同EOS分型慢性阻塞性肺疾病急性加重期患者的预测价值  

Predictive values of sputum ECP and IL-8 for patients with acute exacerbation of chronic obstructive pulmonary disease with different EOS classification

作　　者：犹红 胡系伟 岳龙飞 佟玉峰 YOU Hong;HU Xiwei;YUE Longfei;TONG Yufeng(School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of General Practice,the People's Hospital of Anshun City,Anshun 561000,Guizhou,China)

机构地区：[1]贵州医科大学临床医学院,贵州贵阳550004 [2]贵州医科大学附属医院呼吸与危重症医学科,贵州贵阳550004 [3]安顺市人民医院全科医学科,贵州安顺561000

出　　处：《贵州医科大学学报》2024年第6期873-881,共9页Journal of Guizhou Medical University

基　　金：贵州省卫生健康委科学技术基金(gzwjkj2020-1-047)。

摘　　要：目的探讨痰嗜酸性粒细胞阳离子蛋白(ECP)及白细胞介素-8(IL-8)对嗜酸性粒细胞(EOS)增高型及非EOS增高型慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床预测价值,分析以EOS百分比及绝对值分类AECOPD患者的临床特征、炎症指标的差异。方法72名AECOPD住院患者根据EOS百分比(EOS%)分为非增高型1组(EOS%<2%)和增高型1组(EOS%≥2%),根据EOS绝对值(|EOS|)分为非增高型2组(|EOS|<10^(5)个/L)和增高型2组(|EOS|≥10^(5)个/L),t检验、秩和检验及χ2检验比较不同EOS分型AECOPD患者的痰液中ECP、IL-8水平、临床特征及外周血炎症指标的差异,采用Spearman分析外周血EOS与炎症指标和痰液ECP、IL-8的相关性,采用ROC曲线评价痰ECP、IL-8及外周血炎症指标对不同EOS分型AECOPD的预测价值。结果同种分类下比较,EOS非增高型1组、2组患者的中性粒细胞(NEU)、中性粒细胞百分比(NEUR)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、纤维蛋白原/白蛋白(FAR)、C反应蛋白(CRP)、纤维蛋白原(FIB)、痰IL-8、过去1年急性加重次数、改良英国研究理事会呼吸困难指数(mMRC评分)及慢阻肺评估测试(CAT评分)均高于EOS增高型1组、2组AECOPD患者(P<0.05),淋巴细胞计数(LYM)、淋巴细胞百分比(LYM%)及痰ECP低于EOS增高型1组、2组AECOPD患者;非EOS增高型1组患者中的白细胞(WBC)高于EOS增高型1组患者、差异有统计学意义(P<0.05),非EOS增高型2组与EOS增高型2组患者的WBC水平差异无统计学意义(P>0.05);外周血EOS与痰中ECP呈正相关、与痰中IL-8及外周血NLR、NEU、NEUR、CRP、PLR、FAR呈负相关(P<0.05);ROC曲线分析提示,痰ECP及IL-8、外周血NLR、CRP及FAR对于不同EOS分型AECOPD的预测价值具有统计学意义(P<0.05)。结论EOS非增高型AECOPD较EOS增高型AECOPD住院患者的临床症状、炎症反应更严重,更易发生细菌感染,痰中ECP、IL-8及外周血炎症指标对AECOPD患者分型有一定价值。Objective To investigate clinical predictive values of sputum eosinophil cationic protein(ECP)and interleukin-8(IL-8)for patients with elevated eosinophil(EOS)acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and patients with non-EOS AECOPD.The patients with AECOPD were classified by EOS percentage and absolute value,and the differences in clinical characteristics and inflammatory indicators were analyzed between these classified patients.Methods A total of 72 AECOPD inpatients were divided into non-elevated type 1 group(EOS%<2%)and elevated type 1 group(EOS%≥2%)based on the percentage of EOS(EOS%).According to the absolute value of EOS(|EOS|),they were divided into non-elevated type 2 group(|EOS|<10^(5)/L)and elevated type 2 group(|EOS|≥10^(5)/L).t-test,rank sum test and χ^(2) test were used to compare the differences in sputum ECP,IL-8,clinical characteristics and inflammatory indexes in peripheral blood between AECOPD patients with different EOS classifications.Spearman correlation was used to analyze the association of peripheral blood EOS with inflammatory indexes,sputum ECP and IL-8.ROC curve was used to evaluate the predictive values of sputum ECP,IL-8,and inflammatory indicators in peripheral blood for AECOPD with different EOS classifications.Results Under the same classification,non-elevated type 1 and type 2 groups had neutrophil(NEU),percentage of neutrophil(NEUR),neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),fibrinogen-albumin ratio(FAR),C-reactive protein(CRP),fibrinogen(FIB),sputum IL-8,the times of acute exacerbations in the past year,modified Medical Research Council(mMRC)score and COPD assessment test(CAT)higher than elevated typ e 1 and type 2 groups had(P<0.05),while their LYM,LYM%,and sputum ECP were lower than those of elevated type 1 type 2 groups.White blood cell(WBC)was higher in non-elevated type 1 group than that in elevated type 1 group(P<0.05).There was no significant difference in WBC level between non-elevated type 2 group and elevation type

关 键 词：肺疾病 慢性阻塞性 嗜酸性粒细胞 嗜酸性粒细胞阳离子蛋白 白细胞介素-8 

分 类 号：R563.3[医药卫生—呼吸系统]