Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
BMC Pulm Med. 2020 Jan 28;20(1):22. doi: 10.1186/s12890-020-1056-7.
We investigated the association between a combination of two markers, peripheral (PEC) and bronchoalveolar lavage (BAL) eosinophil percentage (BEP), and oxygen requirements in patients with acute eosinophilic pneumonia (AEP).
We retrospectively reviewed the medical records of patients with AEP treated at the Armed Forces Capital Hospital between May 2012 and May 2017. We used correlation analyses to assess the association between PEC/BEP and clinical outcomes in AEP patients. Receiver operating characteristic (ROC) curve analyses were used to calculate the cut-off value for BEP that categorised patients requiring a significant oxygen supply. The BAL/blood eosinophil (BBE) score was introduced to stratify patients with peripheral eosinophilia and elevated BEP. Clinical characteristics and outcomes were compared between the different groups. Multiple logistic regression was performed for significant oxygen requirements using two different models using age, C-reactive protein (CRP), smoking duration, and BBE score (model 1) and age, CRP, BEP, and PEC (model 2).
Among the 338 patients, 99.7% were male, and their mean age was 20.4 ± 1.4 years. Only 0.6% of patients were never smokers and the mean number of smoking days was 26.2 ± 25.4. Correlation analyses revealed that both the PaO/FiO ratio and duration of oxygen supply were associated with BEP. ROC curve analyses indicated a cut-off level of 41.5%. Patients with a high BBE score had favourable outcomes in terms of hypoxemia, hospital days, intensive care unit admission, oxygen supply days, and steroid treatment days. Multiple logistic regression revealed that BEP and BBE score tended to be associated with significant oxygen requirements.
In this study, we revealed that both peripheral and BAL eosinophilia is associated with favourable outcomes in AEP patients.
我们研究了外周（PEC）和支气管肺泡灌洗（BAL）嗜酸性粒细胞百分比（BEP）联合两种标志物与急性嗜酸性肺炎（AEP）患者氧需求之间的关系。
我们回顾性分析了 2012 年 5 月至 2017 年 5 月在武装部队首都医院治疗的 AEP 患者的病历。我们使用相关分析评估 PEC/BEP 与 AEP 患者临床结局之间的关系。采用接收者操作特征（ROC）曲线分析计算 BEP 截断值，将需要大量氧气供应的患者进行分类。引入 BAL/血嗜酸性粒细胞（BBE）评分来分层外周嗜酸性粒细胞增多和升高的 BEP 患者。比较不同组之间的临床特征和结局。使用两种不同的模型（模型 1：年龄、C 反应蛋白（CRP）、吸烟时间和 BBE 评分；模型 2：年龄、CRP、BEP 和 PEC），使用多元逻辑回归分析有显著氧需求的患者。
在 338 例患者中，99.7%为男性，平均年龄为 20.4±1.4 岁。仅有 0.6%的患者从不吸烟，平均吸烟天数为 26.2±25.4 天。相关分析显示，PaO/FiO 比值和氧供时间均与 BEP 相关。ROC 曲线分析表明，截断值为 41.5%。高 BBE 评分的患者在低氧血症、住院天数、重症监护病房入院、氧供天数和激素治疗天数方面的结局较好。多元逻辑回归显示，BEP 和 BBE 评分与显著氧需求有一定的关联。
在这项研究中，我们揭示了外周和 BAL 嗜酸性粒细胞增多均与 AEP 患者的良好结局相关。
