Alshehri Fareed, Alghamdi Muath, Aloqabi Fatinah A, Ibrahim Ahmed, Tayeb Nisreen, Hassosah Mohammed, Abu-Zaid Ahmed, Fan Hanan, Vali Yusuf
Department of Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
Department of Biochemistry and Molecular Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Saudi J Med Med Sci. 2025 Jan-Mar;13(1):53-60. doi: 10.4103/sjmms.sjmms_248_24. Epub 2025 Jan 11.
This study assessed the prevalence of eosinophilic chronic obstructive pulmonary disease (COPD) among a selected Saudi population and examined its correlation with baseline characteristics, clinical outcomes, exacerbation risk, and current management.
This retrospective single-center study was conducted over a 2-year period. The patients were divided into two groups based on the blood eosinophil count at the time of diagnosis: eosinophilic COPD (≥300 cells/μl) and non-eosinophilic COPD (<300 cells/μl) groups.
Overall, 156 patients were included, of which 76 (48.7%) and 80 (51.3%) patients belonged to the eosinophilic and non-eosinophilic COPD groups, respectively. There were no significant differences between both groups regarding age, gender, smoking status, coexisting morbidities, FEV1, FEV1/FVC, and COPD severity (for all, >0.05). Besides, there were no significant differences between both groups regarding the frequency and numbers of exacerbations, emergency room visits, in-patient hospitalizations, and intensive care unit admissions (for all, >0.05). Among patients with eosinophilic COPD, 64 patients (84.2%) were correctly receiving the triple therapy of long-acting β2 agonists + long-acting muscarinic antagonist + inhaled corticosteroids, whereas 4 patients (5.26%) were incorrectly receiving the dual therapy of long-acting β2 agonists + inhaled corticosteroids. Univariate regression analyses revealed that heart failure, GOLD 3 severity, use of triple therapy, and use of non-invasive ventilation were significantly correlated with a higher risk of COPD exacerbation. Conversely, higher FEV1 was significantly correlated with lower risk of COPD exacerbation. The eosinophilic COPD phenotype was not found to be a significant independent variable of COPD exacerbation.
This study found that among Saudi patients with COPD, there was no clinically important relationship between baseline blood eosinophil count and the rate of exacerbation.
本研究评估了特定沙特人群中嗜酸性粒细胞性慢性阻塞性肺疾病(COPD)的患病率,并探讨了其与基线特征、临床结局、急性加重风险及当前治疗的相关性。
本回顾性单中心研究为期2年。根据诊断时的血液嗜酸性粒细胞计数将患者分为两组:嗜酸性粒细胞性COPD(≥300个细胞/μl)组和非嗜酸性粒细胞性COPD(<300个细胞/μl)组。
共纳入156例患者,其中76例(48.7%)和80例(51.3%)患者分别属于嗜酸性粒细胞性和非嗜酸性粒细胞性COPD组。两组在年龄、性别、吸烟状况、并存疾病、第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)及COPD严重程度方面均无显著差异(均P>0.05)。此外,两组在急性加重的频率和次数、急诊就诊、住院及重症监护病房收治情况方面也无显著差异(均P>0.05)。在嗜酸性粒细胞性COPD患者中,64例(84.2%)正确接受了长效β2受体激动剂+长效毒蕈碱拮抗剂+吸入性糖皮质激素三联疗法,而4例(5.26%)错误接受了长效β2受体激动剂+吸入性糖皮质激素双联疗法。单因素回归分析显示,心力衰竭、慢性阻塞性肺疾病全球倡议(GOLD)3级严重程度、三联疗法的使用及无创通气的使用与COPD急性加重风险较高显著相关。相反,较高的FEV1与较低的COPD急性加重风险显著相关。未发现嗜酸性粒细胞性COPD表型是COPD急性加重的显著独立变量。
本研究发现,在沙特COPD患者中,基线血液嗜酸性粒细胞计数与急性加重率之间无临床重要关联。