Department of Medicine, The University of Hong Kong, Pokfulam, China.
Department of Medicine, Queen Mary Hospital, Pokfulam, China.
Clin Respir J. 2023 Jun;17(6):548-555. doi: 10.1111/crj.13624. Epub 2023 Apr 26.
The role of inhaled corticosteroid (ICS) among patients with bronchiectasis remains controversial. There is limited evidence of using baseline eosinophil count (absolute and percentage) as a marker to predict the role of ICS among patients with bronchiectasis.
A retrospective case-control study was conducted in a major regional hospital and tertiary respiratory referral centre in Hong Kong, including 140 Chinese patients with noncystic fibrosis (CF) bronchiectasis, to investigate the exacerbation risks of bronchiectasis among ICS users and nonusers with different baseline eosinophil counts.
ICS user had significantly lower risk to develop bronchiectasis exacerbation with adjusted odds ratio (OR) of 0.461 (95% confidence interval [CI] 0.225-0.945, p-value 0.035). Univariate logistic regression was performed for different cut-offs of blood eosinophil count (by percentage) from 2% to 4% (with a 0.5% grid each time). Baseline eosinophil 3.5% was found to be the best cut-off among all with adjusted OR of 0.138 (95% CI = 0.023-0.822, p-value = 0.030).
Baseline eosinophil count of 3.5% might serve as a marker to predict the benefits of ICS on exacerbation risk among patients with non-CF bronchiectasis.
支气管扩张症患者使用吸入性皮质类固醇（ICS）的作用仍存在争议。目前，使用基线嗜酸性粒细胞计数（绝对值和百分比）作为预测支气管扩张症患者 ICS 作用的标志物的证据有限。
本研究在香港一家主要的区域医院和三级呼吸转诊中心进行了回顾性病例对照研究，共纳入 140 名非囊性纤维化（CF）支气管扩张症的中国患者，旨在调查不同基线嗜酸性粒细胞计数的 ICS 使用者和非使用者发生支气管扩张症加重的风险。
ICS 使用者发生支气管扩张症加重的风险显著降低，调整后的优势比（OR）为 0.461（95%置信区间 [CI] 0.225-0.945，p 值 0.035）。对从 2%到 4%（每次间隔 0.5%）的不同嗜酸性粒细胞百分比（血）截断值进行单变量逻辑回归。发现基线嗜酸性粒细胞 3.5%是所有截断值中最佳截断值，调整后的 OR 为 0.138（95%CI = 0.023-0.822，p 值 = 0.030）。
基线嗜酸性粒细胞计数 3.5%可能是预测非 CF 支气管扩张症患者 ICS 对加重风险获益的标志物。
