[1]崔雨佳,刘　忠.外周血嗜酸性粒细胞水平与慢性阻塞性肺疾病急性加重期患者临床预后的相关性分析[J].现代检验医学杂志,2020,35(03):129-132.[doi:10.3969/j.issn.1671-7414.2020.03.035]
　CUI Yu-jia,LIU Zhong.Relationship between Peripheral Blood Eosinophil Level and the Prognosis of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease[J].Journal of Modern Laboratory Medicine,2020,35(03):129-132.[doi:10.3969/j.issn.1671-7414.2020.03.035]
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外周血嗜酸性粒细胞水平与慢性阻塞性肺疾病急性加重期患者临床预后的相关性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年03期
页码:
129-132
栏目:
检验与临床
出版日期:
2020-07-20

文章信息/Info

Title:
Relationship between Peripheral Blood Eosinophil Level and the Prognosis of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
文章编号:
1671-7414（2020）03-129-05
作者:
崔雨佳; 刘　忠
（锦州医科大学附属第一医院，辽宁锦州　121000）
Author(s):
CUI Yu-jia;  LIU Zhong
（the First Affiliated Hospital of Jinzhou Medical University, Liaoning Jingzhou 121000, China）
关键词:
嗜酸性粒细胞; 慢性阻塞性肺疾病急性加重期; 临床预后; 生存分析
分类号:
R563；R446.11
DOI:
10.3969/j.issn.1671-7414.2020.03.035
摘要:
目的　探讨外周血嗜酸性粒细胞（EOS）水平与慢性阻塞性肺疾病急性加重期（AECOPD）患者临床预后的关系。 方法　选取2016 年9 月~ 2018 年12 月于锦州医科大学附属第一医院住院治疗的AECOPD 患者216 例为研究对象，根 据入院时血细胞检测中EOS 百分比（EOS%）分为EOS 正常组（EOS% ≥ 2%）92 例和EOS 异常组（EOS% ＜ 2%）124 例， 对比分析两组患者的临床资料，并于出院后随访至少1 年，以1 年内再发急性加重为主要研究终点，以因COPD 死亡 为次要研究终点，采用Kaplan-Meier 生存曲线法比较两组患者1 年累积急性加重再发率及3 年累积生存率。结果　EOS 正常组入院时C 反应蛋白、白细胞计数、中性粒细胞计数、住院期间激素使用总量、机械通气使用率、住院时间及住 院费用均显著低于EOS 异常组，差异均有统计学意义（均P<0.05）。EOS 正常组1 年累积急性加重再发率为68.0%， 低于EOS 异常组的84.1%，差异有统计学意义（χ2=19.566, P=0.000）；EOS 正常组3 年累积生存率为70.9%，高于 EOS 异常组的41.8%，差异有统计学意义（χ2=9.925, P=0.002）。结论　外周血EOS 水平对预测AECOPD 患者的治疗 效果及临床预后具有一定的参考价值。
Abstract:
Objective　To explore the relationship between peripheral blood eosinophil (EOS) level and the prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods　216 patients with AECOPD who treated in the First Affiliated Hospital of Jinzhou Medical University were divided into two groups according to their admission eosinophil fractions (EOS%). Patients with EOS% ≥ 2% were in the EOS normal group (n=92), while patients with EOS%<2% were in the EOS abnormal group (n=124). The clinical data of the two groups were compared. Patients in both groups were followed up for at least 1 year after discharge. The main end point was acute exacerbation of COPD within 1 year, and the secondary end point was death due to COPD. The 1 year acute exacerbation recurrence rate and 3 year survival rate between two groups were compared by Kaplan-meier survival curve method. Results　Compared with EOS abnormal group, patients in EOS normal group had lower levels of C-reactive protein, white blood cell count, neutrophils count, total hormone use during hospitalization, rate of mechanical ventilation, length of hospitalization, and hospitalization cost (all P<0.05). The 1 year acute exacerbation recurrence rate in EOS normal group was lower than those of EOS abnormal group (68.0% vs 84.1%, χ2=19.566，P=0.000) and the 3 year survival rate in EOS normal group was higher than those of EOS abnormal group (70.9% vs 41.8%, χ2=9.925，P=0.002). Conclusion　The peripheral blood EOS levels are useful in predicting the therapeutic effect and clinical prognosis of AECOPD patients.

参考文献/References:

[1]　李军民, 白晓, 孟茜, 等.COPD 患者血清降钙素 原水平与肺功能的关系研究[J]. 现代检验医学杂 志,2018,33(1):148-150. 　　 LI Junmin, BAI Xiao, MENG Qian, et al. Relationship study on serum levels of procalcitonin and pulmonary function in patients with chronic obstructive pulmonary disease [J]. Journal of Modern Laboratory Medicine, 2018,33(1):148-150.
[2]　邱淑佳. 慢性阻塞性肺疾病患者血清LCN1 和 LCN2 的表达水平及临床意义[J]. 现代检验医学杂 志,2017,32(6):67-70,73. QIU Shujia. Expression levels of serum LCN1 and LCN2 in patients with acute exacerbation of chronic obstructive pulmonary disease and its clinical significance [J]. Journal of Modern Laboratory Medicine, 2017,32(6):67-70,73.
[3]　BORIAK V P, SHUT S V, TRYBRAT T A, et al. Condition of hemodynamics in the pulmonary circulation of patients with chronic obstructive pulmonary disease (copd) concurrent with metabolic syndrome with hypertrophy and atrophy of the myocardium [J]. Wiad Lek, 2019,72(8):1491-1493.
[4]　赵新成, 史家欣, 梁程程, 等. 嗜酸性粒细胞作为生 物标志物在慢性阻塞性肺疾病中的研究进展[J]. 中 国呼吸与危重监护杂志,2018,17(6):624-628. 　　 ZHAO Xincheng, SHI Jiaxin, LIANG Chengcheng, et al. Advances in eosinophil as a biomarker in chronic obstructive pulmonary disease [J]. Chinese Journal of Respiratory and Critical Care Medicine, 2018,17(6):624- 628.
[5]　CELLI B R, CRINER G J. Using the peripheral blood eosinophil count to manage patients with chronic obstructive pulmonary disease [J]. Ann Am Thorac Soc, 2019,16(3):301-303.
[6]　金晓晴, 陈波, 王颖, 等. 外周血嗜酸粒细胞对重症 慢阻肺急性加重期患者疗效及预后评价的研究[J]. 武汉大学学报（医学版）,2017,38(3):475-478. JIN Xiaoqing, CHEN Bo, WANG Ying, et al. Relationship between blood eosinophils and prognosis or treatment outcomes of severe AECOPD [J]. Medical Journal of Wuhan University, 2017,38(3):475-478.
[7]　　费海涛, 胡蓉, 朱述阳, 等. 慢性阻塞性肺疾病急性 加重期患者嗜酸性粒细胞百分比与预后关系研究 [J]. 临床军医杂志,2019,47(12):1340-1341. FEI Haitao, HU Rong, ZHU Shuyang, et al. Relationship between percentage of eosinophil and prognosis in patients with acute exacerbation of chronic obstructive pulmonary disease [J]. Clinical Journal of Medical Officers, 2019,47(12):1340-1341.
[8]　　杨宏宽，张艳，张佳颖，等。哮喘- 慢性阻塞性肺 疾病重叠患者中痰髓过氧化物酶，嗜酸粒细胞阳离 子蛋白与临床特征的相关性[J].南方医科大学学报， 2018, 38（10）: 1215-1221. Yang Hongkuan, ZHANG Yan, ZHANG Jiaying, et al. Correlation between expressions of myeloperoxidase and eosinophil cationic protein in sputum and clinical features of asthma-chronic obstructive pulmonary disease overlap [J]. Journal of Southerm Medical University, 2018, 38(10):1215-1221.
[9]　　付立娜, 王珺, 蔡成森, 等. 嗜酸粒细胞与慢性阻塞 性肺疾病患者激素治疗及预后关系的研究进展[J]. 实用心脑肺血管病杂志,2019,27(6):5-7. 　　 FU Lina, WANG Jun, CAI Chengsen, et al. Progress on relations of eosinophils to hormonal therapy and prognosis in patients with chronic obstructive pulmonary disease [J]. Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease, 2019,27(6):5-7.
[10] CUKIC V. Blood count of eosinophil polymorphonuclear leucocytes and bronchial hyperreactivity in chronic obstructive pulmonary disease [J]. Med Arch, 2017,71(5):347-350.
[11] ZEIGER R S, TRAN T N, BUTLER R K, et al. Relationship of blood eosinophil count to exacerbations in chronic obstructive pulmonary disease [J]. J Allergy Clin Immunol Pract, 2018,6(3):944-954.
[12] CHEN Peiku, HSIAO Y H, PAN Shengwei, et al. Independent factors associate with hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease requiring intensive care unit admission: Focusing on the eosinophil-to-neutrophil ratio [J]. PLoS One, 2019, 14(7):e0218932.
[13] TORALDO D M, CONTE L. Influence of the lung microbiota dysbiosis in chronic obstructive pulmonary disease exacerbations: The controversial use of corticosteroid and antibiotic treatments and the role of eosinophils as a disease marker [J]. J Clin Med Res, 2019,11(10):667-675.
[14] PASCOE S, BARNES N, BRUSSELLE G, et al. Blood eosinophils and treatment response with triple and dual combination therapy in chronic obstructive pulmonary disease: analysis of the IMPACT trial [J]. Lancet Respir Med, 2019,7(9):745-756.
[15] 薛瑾, 崔亚楠, 陈平, 等. 血嗜酸粒细胞对慢性阻塞 性肺疾病急性加重期激素治疗反应性和再入院的预 测价值[J]. 中华结核和呼吸杂志,2019,42(6):426-431. 　　 XUE Jin, CUI Yanan, CHEN Ping, et al. Blood eosinophils: a biomarker of response to glucocorticoids and increased readmissions in severe hospitalized exacerbations of COPD [J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2019,42(6):426-431.
[16] 佟飞, 李研, 张秋. 外周血嗜酸性粒细胞计数与慢性 阻塞性肺疾病患者病情加重的相关性分析[J]. 临床 肺科杂志,2019,24(5):936-938. 　　 TONG Fei, LI Yan, ZHANG Qiu, et al. Correlation analysis between eosinophil count in peripheral blood and exacerbation of chronic obstructive pulmonary disease [J]. Journal of Clinical Pulmonary Medicine, 2019,24(5):936-938.

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备注/Memo

备注/Memo:
收稿日期：2020-02-02 修回日期：2020-02-18作者简介：崔雨佳（1994-），女，硕士研究生，医师，研究方向：慢性阻塞性肺疾病急性加重期的诊治，E-mail：cuiyj5180@126.com。 通讯作者：刘忠（1968-），女，硕士，主任医师，研究方向：慢性阻塞性肺疾病急性加重期的诊治，E-mail：sunnally@126.com
更新日期/Last Update: 2020-07-20