Bedolla-Barajas Martín, Raúl Ortiz-Peregrina José, Daniel Hernández-Colín Dante, Morales-Romero Jaime, Ramses Bedolla-Pulido Tonatiuh, Larenas-Linnemann Désirée
Servicio de Alergia e Inmunología Clínica, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca ," Salvador de Quevedo y Zubieta No. 750, Colonia La Perla , Guadalajara , Jalisco , CP. 44340 , México.
Servicio de Neumología, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" , Salvador de Quevedo y Zubieta No. 750, Colonia La Perla , CP. 44340 , Guadalajara , Jalisco , México.
J Asthma. 2019 Nov;56(11):1138-1146. doi: 10.1080/02770903.2018.1520863. Epub 2018 Nov 5.
To identify and characterize asthma with blood eosinophilia in adults. : This cross-sectional study consisted of 164 asthma patients, aged 18 years or older. Multivariate analyses by logistic regression were performed to identify clinical characteristics and biomarkers associated with asthma with blood eosinophilia (defined as asthma and a peripheral blood eosinophil count ≥400 cells/mm). To evaluate the diagnostic accuracy of these biomarkers, the sensitivity, specificity and predictive values were calculated. Additionally, the area under the receiver operating characteristic (ROC) curve (AUC) was estimated for each biomarker. : Overall, 37.8% (95%CI: 30.7-45.4%) of asthma patients had blood eosinophilia. The following factors were associated with this characteristic: patient age <50 years (OR 3.25; 95% CI: 1.33-7.94), a serum level of IgE ≥300 UI/mL (OR 2.32; 95%CI: 1.14-4.75), and an Asthma Control Test (ACT) score <20 points (OR 3.10; 95%CI: 1.35-4.75); asthma with blood eosinophilia was also associated with a baseline FEV/FVC <70% (OR 2.68; 95%CI: 1.28-5.59). On the other hand, age <50 years and ACT score <20 showed the highest sensitivity (above 80% each). Serum IgE level ≥300 UI/mL had the highest specificity (almost 68%). Finally, those with an ACT score <20 had the highest AUC (68%). : In our study population, one-third of asthmatic adults had asthma with blood eosinophilia. Furthermore, the prevalence was greater in those ≤50 years of age; these patients experienced more severe, more poorly controlled asthma and had higher total serum IgE levels.
识别和描述成人嗜酸性粒细胞增多性哮喘。:这项横断面研究包括164名18岁及以上的哮喘患者。采用逻辑回归进行多变量分析,以确定与嗜酸性粒细胞增多性哮喘(定义为哮喘且外周血嗜酸性粒细胞计数≥400个细胞/mm)相关的临床特征和生物标志物。为评估这些生物标志物的诊断准确性,计算了敏感性、特异性和预测值。此外,还估计了每个生物标志物的受试者工作特征(ROC)曲线下面积(AUC)。:总体而言,37.8%(95%CI:30.7 - 45.4%)的哮喘患者有嗜酸性粒细胞增多。以下因素与该特征相关:患者年龄<50岁(OR 3.25;95%CI:1.33 - 7.94)、血清IgE水平≥300 UI/mL(OR 2.32;95%CI:1.14 - 4.75)以及哮喘控制测试(ACT)评分<20分(OR 3.10;95%CI:1.35 - 4.75);嗜酸性粒细胞增多性哮喘还与基线FEV/FVC<70%相关(OR 2.68;95%CI:1.28 - 5.59)。另一方面,年龄<50岁和ACT评分<20显示出最高的敏感性(各高于80%)。血清IgE水平≥300 UI/mL具有最高的特异性(近68%)。最后,ACT评分<20的患者具有最高的AUC(68%)。:在我们的研究人群中,三分之一的成年哮喘患者患有嗜酸性粒细胞增多性哮喘。此外,≤50岁的患者患病率更高;这些患者经历更严重、控制更差的哮喘,且总血清IgE水平更高。