The lower the eosinophils, the stronger the inflammatory response? The relationship of different levels of eosinophils with the degree of inflammation in acute exacerbation chronic obstructive pulmonary disease (AECOPD).
The lower the eosinophils, the stronger the inflammatory response? The relationship of different levels of eosinophils with the degree of inflammation in acute exacerbation chronic obstructive pulmonary disease (AECOPD).
复制标题
嗜酸性粒细胞越低，炎症反应越强？
DOI：
10.21037/jtd-20-2178
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发表时间：
2021-01
影响因子：
2.5
通讯作者：
Jin SD
中科院分区：
文献类型：
--
作者：
Lv MY;Qiang LX;Li ZH;Jin SD
血液嗜酸性粒细胞水平是慢性阻塞性肺疾病（COPD）患者治疗效果的已知标志物。本研究旨在明确血嗜酸性粒细胞（EOS）预测COPD急性加重期（AECOPD）急性加重风险和预后的临界值，并探讨其与炎症指标和临床特征的相关性。方法对174例AECOPD患者进行EOS与COPD的相关性研究。根据血EOS百分比将患者分为两组（第1组：EOS <2%，n=98;第2组：EOS ≥ 2%，n=76），第2组根据4%的临界值进一步分为A组（2%≤ EOS <4%）和B组（EOS ≥4%）。采集外周血标本后进行规范化治疗。比较EOS与住院治疗前实验室指标及临床资料的相关性。结果与第2组相比，第1组患者炎症反应严重，肺功能差，住院时间长（P<0.001），mMRC评分高（P <0.05），CAT评分高（P<0.05），死亡率高（P<0.05），无创机械通气使用率高（P<0.05）。A组CRP、总mMRC、CAT评分均显著低于B组（P<0.001; P<0.01; P<0.05）。Pearson相关分析显示，血嗜酸性粒细胞百分比低与白细胞计数（r=-0.155，P<0.05）、NLR（r=-0.227，P<0.01）和CRP（r=-0.308，P<0.01）呈负相关。结论血EOS百分比的不同临界值可能是预测AECOPD患者急性加重程度和预后的有用生物标志物。
Background Blood eosinophil levels are a known marker for the effects of therapy in patients with chronic obstructive pulmonary disease (COPD). This study aimed to clarify the cutoff values for blood eosinophils (EOS) to predict exacerbation risk and prognosis of acute exacerbation COPD (AECOPD) and investigate their correlation using inflammatory indicators and clinical characteristics. Methods In this observational study of 174 patients with AECOPD, we assessed the relationship between EOS and COPD. According to the percentage of blood EOS, patients were grouped into two groups (Group 1: EOS <2%, n=98; Group 2: EOS ≥2%, n=76), and Group 2 was further divided into Group A (2%≤ EOS <4%) and Group B (EOS ≥4%) based on a cutoff value of 4%. Patients received standardized treatment after collection of peripheral blood specimen. Associations of EOS with laboratory indicators before any treatment in hospital and with clinical data were compared. Results Patients in Group 1 showed significantly severe inflammation, worse pulmonary function, longer length of stay (LOS) (P<0.001), higher mMRC score (P<0.05), higher CAT score (P<0.05), higher rates of mortality (P<0.05), and greater noninvasive mechanical ventilation usage (P<0.05) compared with Group 2. Intriguingly, the CRP, total mMRC and CAT scores of patients in Group A were significantly lower than those in Group B (P<0.001; P<0.01; P<0.05, respectively). Pearson correlation analysis showed that a low percentage blood eosinophil level was negatively associated with higher WBC count (r=–0.155, P<0.05), NLR (r=–0.227, P<0.01) and CRP (r=–0.308, P<0.01). Conclusions Different cutoff values for percentage blood EOS might be useful biomarkers for predicting the severity of exacerbation and prognosis of inpatients with AECOPD.