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慢性阻塞性肺疾病患者血嗜酸粒细胞分布及临床特征

The distribution of blood eosinophils and the related clinical characteristics in chronic obCOPD patients

摘要:

目的:分析社区与门诊慢性阻塞性肺疾病(慢阻肺)患者的血嗜酸粒细胞(EOS)分布,并研究高EOS型慢阻肺患者的临床特征和相关因素。方法:本研究纳入237例稳定期慢阻肺患者,其中男193例,女44例,年龄范围58~76岁,中位数为68岁,45例来源于2012—2013年“中国成人肺部健康”流行病学调查获取的社区患者,192例为2013年8月至2014年11月以及2015年9月至2018年5月期间就诊于北京大学第三医院呼吸科门诊的患者。以血EOS计数100 个/μl为界值,分为高EOS组(146例)和低EOS组(91例),比较患者的人口学特征、呼吸道症状、急性加重、肺功能、炎症、影像学等指标。结果:社区慢阻肺患者的血EOS中位数为111.4 个/μl,门诊患者中位数为110.0 个/μl,二者差异无统计学意义( P>0.05)。总体患者的EOS计数中位数为110.0 个/μl,EOS百分比中位数为1.8%。高EOS组中,EOS≥300 个/μl占11.4%。高EOS组男性比例较高(85.6%比74.7%),GOLD分级较重,中性粒细胞百分比较低(61.7%比64.7%),差异均有统计学意义( P<0.05)。多因素分析后,高EOS与患者年龄增加( OR=1.035,95% CI:1.004~1.067, P=0.029)、GOLD分级较重( P=0.015)以及中性粒细胞百分比较低( OR=0.956,95% CI:0.923~0.991, P=0.015)存在相关性。 结论:社区和门诊慢阻肺患者的血EOS分布无明显差异。约60%的慢阻肺患者血EOS≥100 个/μl,与高龄、男性、严重气流受限和低中性粒细胞相关。

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abstracts:

Objective:To analyze the distribution of blood eosinophils (EOS) in COPD patients in the community and outpatient clinics, and to study the clinical characteristics and influencing factors of COPD patients with high EOS counts.Methods:This study included 237 patients with stable COPD, of which the median age was 68 years and males accounted for 81.2%. There were 45 community patients from the China Pulmonary Health study conducted in 2012-2013 and another 192 outpatients who attended the Respiratory Department of Peking University Third Hospital from August 2013 to November 2014 or from September 2015 to May 2018. Taking 100 cells/μl as the cut-off value, it was divided into high EOS group (146 people, 61.6%) and low EOS group (91 people, 38.4%). We compared demographic characteristics, respiratory symptoms, acute exacerbation, lung function, inflammation, imaging and other indicators.Results:The median EOS count of community patients was 110.4 cells/μl, and that of outpatients was 110.0 cells/μl. There was no statistically significant difference in the distribution of blood EOS among community and outpatients. The median EOS count of the general population was 110.0 cells/μl, and the median percentage was 1.8%. EOS≥300 cells/μl accounted for 11.4%. In the high EOS group, the percentage of male gender was higher (85.6% vs 74.7%), the GOLD grade was more severe, and the percentage of neutrophils was lower (61.70% vs 64.70%) ( P<0.05 for these three characteristics). After multivariate analysis, the high EOS group was closely related to older age ( OR=1.035, 95% CI:1.004-1.067, P=0.029), heavier GOLD grade ( P=0.015) and lower percentage of neutrophils ( OR=0.956, 95% CI:0.923-0.991, P=0.015). Conclusion:The distribution of blood EOS of COPD patients between the community and the outpatient clinics is not significantly different. About 60% of COPD patients have blood EOS≥100 cells/μl, which is associated with advanced age, male, severe airflow limitation, and low neutrophils.

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作者: 郑丹蕾 王红梅 刘耘充 王蕾 高荣 廖艺璇 白宇 孙婉璐 陈亚红
期刊: 《中华结核和呼吸杂志》2021年44卷3期 218-224页 MEDLINEISTICPKUCSCD
栏目名称: 论著
DOI: 10.3760/cma.j.cn112147-20200617-00715
发布时间: 2021-04-06
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