Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China.
Department of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan 030032, China.
Heart Lung. 2022 Nov-Dec;56:29-39. doi: 10.1016/j.hrtlng.2022.05.012. Epub 2022 Jun 7.
Eosinophils are thought to be associated with the frequency and severity of acute exacerbations of chronic obstructive pulmonary disease (AECOPD); however, the role of eosinophilic inflammation in AECOPD is still incompletely understood.
To investigate the relationship between different levels of blood eosinophils and clinical features, including comorbidities, therapy, and prognosis, and to further explore the optimal eosinophilic cutoff.
We retrospectively collected and analyzed medical data, laboratory findings, chest CT images, treatment, and three-year follow-up data from 984 AECOPD patients with different blood eosinophil (EOS) levels: EOS%<2%, ≥2%; EOS%<3%, ≥3%; eosinophil counts<100 cells/L, ≥100 cells/L.
The prevalence of eosinophilia was 36.48% of EOS≥2% (359 cases), 22.87% of EOS≥3% (225 cases), and 48.48% with eosinophil counts≥100 cells/µl (477 cases). EOS was associated with comorbidities, including pulmonary heart disease, arrhythmia (atrial fibrillation), laboratory testing and clinical treatment, including respiratory failure, airway limitation, infectious inflammation, rate of antibiotic use, systemic glucocorticoids, and three mortality rates. The ROC curve showed that the indicators of AUC≥0.5 included chest CT imaging (emphysema 1.8% or ≥100/µl, bronchitis, 1.7% or ≥100/µl), osteoporosis (2.4% or ≥140/µl), mental illness 6.1% (or ≥400/µl), dust exposure (2.2% or ≥240/µl) and ex-smoker (1.3% or ≥100/µl).
The relatively higher EOS group (≥2% or ≥100/µl) was associated with fewer complications, mild airflow limitation, a tendency of noninfectious inflammation, and lower 3-year mortality. Eosinophils can not only guide clinical treatment but also be an indicator of predicting clinical outcome and prognosis in AECOPD patients.
嗜酸性粒细胞被认为与慢性阻塞性肺疾病（COPD）急性加重（AECOPD）的频率和严重程度有关；然而，嗜酸性粒细胞炎症在 AECOPD 中的作用仍不完全清楚。
探讨不同水平的血嗜酸性粒细胞与临床特征（包括合并症、治疗和预后）之间的关系，并进一步探讨最佳嗜酸性粒细胞截断值。
我们回顾性地收集并分析了 984 例不同血嗜酸性粒细胞（EOS）水平的 AECOPD 患者的医疗数据、实验室检查结果、胸部 CT 图像、治疗和 3 年随访数据：EOS%<2%，≥2%；EOS%<3%，≥3%；嗜酸性粒细胞计数<100 细胞/L，≥100 细胞/L。
EOS≥2%（359 例）、EOS≥3%（225 例）和嗜酸性粒细胞计数≥100 细胞/µl（477 例）的嗜酸性粒细胞增多发生率分别为 36.48%、22.87%和 48.48%。EOS 与合并症（包括肺心病、心律失常（心房颤动））、实验室检查和临床治疗（包括呼吸衰竭、气道受限、感染性炎症、抗生素使用率、全身糖皮质激素和 3 年死亡率）有关。ROC 曲线显示 AUC≥0.5 的指标包括胸部 CT 成像（肺气肿 1.8%或≥100/µl、支气管炎 1.7%或≥100/µl）、骨质疏松症（2.4%或≥140/µl）、精神疾病 6.1%（或≥400/µl）、粉尘暴露（2.2%或≥240/µl）和戒烟者（1.3%或≥100/µl）。
相对较高的 EOS 组（≥2%或≥100/µl）与并发症较少、轻度气流受限、非感染性炎症倾向和较低的 3 年死亡率有关。嗜酸性粒细胞不仅可以指导临床治疗，而且可以作为预测 AECOPD 患者临床结局和预后的指标。
