The stability of blood eosinophils in stable chronic obstructive pulmonary disease: a retrospective study in Belgian primary care
The stability of blood eosinophils in stable chronic obstructive pulmonary disease: a retrospective study in Belgian primary care
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稳定型慢性阻塞性肺疾病患者血液嗜酸性粒细胞的稳定性：比利时初级保健的回顾性研究
DOI：
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发表时间：
2020
影响因子：
3.1
通讯作者：
E. Vanderhelst
中科院分区：
文献类型：
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作者：
Inès Van Rossem;J. Vandevoorde;S. Hanon;S. Deridder;E. Vanderhelst
血嗜酸性粒细胞计数（BEC）最近被纳入2019年全球阻塞性肺疾病倡议（GOLD）指南，作为慢性阻塞性肺疾病（COPD）的一种易于获得的治疗不确定性生物标志物。然而，BEC的稳定性仍然没有得到充分的研究。方法我们对比利时6个初级保健机构的稳定期COPD患者的电子健康记录数据进行了回顾性研究，以确定血液嗜酸性粒细胞随时间的稳定性。我们报告了BEC持续低于或高于2019年GOLD指南阈值（100和300个细胞/μL）的患者百分比。计算每例患者BEC的平均值、标准差（SD）和相对标准差（RSD），以确定患者内变异性。结果98例患者被纳入，产生1082个嗜酸性粒细胞测量值（中位数8个测量值/患者），BEC范围为0至1504个细胞/μL。4例（4.1%）患者的BEC持续低于100个细胞/μL，34例（34.7%）患者的测量值持续高于此阈值。大约一半患者（51.0%）的BEC持续低于300个细胞/μL，3例（3.1%）患者的计数持续高于该阈值。在整个登记期间，28.6%的患者超过了两个阈值。每例患者的平均BEC范围为15 - 846个细胞/μL，患者内SD范围为5 - 658个细胞/μL。平均患者内RSD为0.46。平均BEC和SD之间存在显著的强正相关（Pearson分析）（r = 0.765; n = 98）。简单线性回归用于进一步描述平均嗜酸性粒细胞计数对SD的影响（B = 0.500; 95%CI 0.415-0.586; n = 98; p < 0.001）。结论COPD患者BEC存在个体差异。因此，使用单一测量来指导治疗决策仍然是有争议的。进一步的前瞻性研究仍然是必要的，以验证这种生物标志物的重现性。
Background Blood eosinophil counts (BEC) were recently included in the 2019 Global Initiative for Obstructive Lung Disease (GOLD) guideline as an easily accessible theragnostic biomarker for Chronic Obstructive Pulmonary Disease (COPD). However, the stability of BEC remains insufficiently studied. Methods We conducted a retrospective study in six primary care practices in Belgium on data from Electronic Health Records of stable COPD patients, to characterise the stability of blood eosinophils over time. We report the percentage of patients with BEC persistently below or above the 2019 GOLD guideline thresholds (100 and 300 cells/μL). For each patient the mean, standard deviation (SD) and relative standard deviation (RSD) of the BEC were calculated to determine the intra-patient variability. Results Ninety-eight patients were included, yielding 1082 eosinophil measurements (median 8 measurements/patient), with BEC ranging between 0 and 1504 cells/μL. Four (4.1%) patients had BEC persistently below 100 cells/μL, 34 (34.7%) had measurements persistently above this threshold. Approximately half of the patients (51.0%) had BEC persistently below 300 cells/μL and 3 (3.1%) patients had counts persistently above this threshold. 28.6% of patients crossed both threshold values throughout the registration period. The mean BEC per patient ranged between 15 and 846 cells/μL with an intra-patient SD between 5 and 658 cells/μL. The mean intra-patient RSD was 0.46. There was a significant strong positive correlation (Pearson analyses) between the mean BEC and SD ( r = 0.765; n = 98). Simple linear regression was used to further describe the influence of the mean eosinophil count on the SD (B = 0.500; 95%CI 0.415–0.586; n = 98; p < 0.001). Conclusion BEC can be variable in individual COPD patients. Therefore, the use of a single measurement to guide therapeutic decisions remains debatable. Further prospective research remains necessary to validate the reproducibility of this biomarker.