Adir Yochai, Hakrush Omar, Shteinberg Michal, Schneer Sonia, Agusti Alvar
Pulmonary Division, Lady Davis Carmel Medical Center, Faculty of Medicine, The Technion Institute of Technology, Haifa, Israel.
Respiratory Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona and CIBER Enfermedades Respiratorias (CIBERES), Spain.
ERJ Open Res. 2018 Aug 3;4(3). doi: 10.1183/23120541.00022-2018. eCollection 2018 Jul.
Whether the level of circulating eosinophils in chronic obstructive pulmonary disease (COPD) patients can predict the risk of exacerbations of COPD (ECOPD) or response to treatment is debated. Here, we evaluate the prevalence of elevated eosinophils in COPD patients and its relationship with severe ECOPD requiring hospitalisation. We retrospectively reviewed the charts of COPD patients hospitalised in our centre between January 1, 2005 and November 30, 2015 because of ECOPD or other reasons (controls). In a second analysis, the ECOPD patients were divided into two subgroups based on having ECOPD in the next year after the index event or not. Circulating eosinophils, both during clinical stability and hospitalisation, as well as clinical and functional data and the relation to recurrent exacerbations were analysed. We studied 992 COPD patients (318 ECOPD patients and 674 controls). Among ECOPD patients, 121 had one or more ECOPD during the year after the index event. The prevalence of eosinophils ≥2% was 72% in ECOPD patients and 71% in controls (p=0.93). Among ECOPD patients, eosinophil levels ≥2%, ≥4% or ≥300 cells·μL, either when clinically stable or during hospitalisation, did not show a significant association with the rate of recurrent severe exacerbations. The severity of airflow limitation was associated with recurrent exacerbations, but inhaled corticosteroid treatment was not. The majority of COPD patients have circulating eosinophils >2% and a significant association with the risk of severe ECOPD or response to inhaled corticosteroids was not demonstrated.
慢性阻塞性肺疾病（COPD）患者循环嗜酸性粒细胞水平能否预测COPD急性加重（ECOPD）风险或治疗反应仍存在争议。在此，我们评估COPD患者嗜酸性粒细胞升高的患病率及其与需要住院治疗的严重ECOPD的关系。我们回顾性分析了2005年1月1日至2015年11月30日期间因ECOPD或其他原因（对照组）在本中心住院的COPD患者的病历。在第二项分析中，根据指数事件后次年是否发生ECOPD，将ECOPD患者分为两个亚组。分析了临床稳定期和住院期间的循环嗜酸性粒细胞，以及临床和功能数据与复发急性加重的关系。我们研究了992例COPD患者（318例ECOPD患者和674例对照组）。在ECOPD患者中，121例在指数事件后的一年内发生了一次或多次ECOPD。ECOPD患者中嗜酸性粒细胞≥2%的患病率为72%，对照组为71%（p=0.93）。在ECOPD患者中，临床稳定期或住院期间嗜酸性粒细胞水平≥2%、≥4%或≥300个/μL与严重复发急性加重率均无显著相关性。气流受限的严重程度与复发急性加重相关，但吸入糖皮质激素治疗与之无关。大多数COPD患者循环嗜酸性粒细胞>2%，且未证明其与严重ECOPD风险或对吸入糖皮质激素的反应存在显著相关性。
