| 张雪,荣光生,钱晓君,等.慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞的临床应用价值[J].安徽医药,2021,25(7):1392-1395. |
| 慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞的临床应用价值 |
| Clinical value of blood eosinophils in acute exacerbation of chronic obstructive pulmonary disease |
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| DOI：10.3969/j.issn.1009-6469.2021.07.030 |
| 中文关键词: 肺疾病，慢性阻塞性 嗜酸性粒细胞 呼吸困难 C反应蛋白 糖皮质激素类 急性加重 |
| 英文关键词: Pulmonary disease, chronic obstructive Eosinophils Dyspnea C-Reactive protein Glucocorticoids Acute exacerbation |
| 基金项目:合肥市卫生计生委 2016应用医学项目( hwk2016yb008) |
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| 中文摘要: |
| 目的分析不同水平血嗜酸性粒细胞( EOS)在慢性阻塞性肺疾病急性加重期( AECOPD)的临床特点，探讨血 EOS的临床应用价值。方法选取 2018年 1月 1日至 2019年 5月 31日合肥市第三人民医院住院诊断 AECOPD的 197例病人，以入院血常规中 EOS百分比( EOS%)分为两组， EOS%<2%为阴性组( 138例)EOS%≥2%为阳性组( 59例)。对比分析两组病人临床特征、实验室检查结果、住院时间及糖皮质激素治疗反应性。结果阳性，组病人慢阻肺评估测试( CAT)分值、改良英国研究理事会呼吸困难指数( mMRC)分值、 C-反应蛋白( CRP)、中性粒细胞与淋巴细胞比值( NLR)水平低于阴性组，慢性阻塞性肺疾病全球倡议( GOLD)Ⅱ级分布率 40.7%(24/59)高于阴性组 14.5%(20/138)，住院时间 10.9(5~38)d短于阴性组 13.6(5~45)d(P=0.047)糖皮质激素用量( 181±200)mg少于阴性组( 351±301)mg(P<0.001)治疗第 7天 CAT分值较入院当天改善( △CAT)≥2者占 96%(57/59)，高于阴性组 80.4%(111/138)(P=0.003)。使用糖皮质治疗的病人阳性组 △CAT≥2者占 95.9%(47/49)，高于阴性组 80.6%(104/129)(P=0.011)。结论在慢性阻塞性肺疾病急性加重期血 EOS水平对预测细菌感染水平、糖皮质激.6，激素，素的治疗反应具有参考价值。 |
| 英文摘要: |
| Objective To analyze the clinical characteristics of blood eosinophils (EOS) at different levels in acute exacerbation ofchronic obstructive pulmonary disease (AECOPD), and to explore the clinical application value of eosinophils.Methods A total of 197 hospitalized patients diagnosed as AECOPD in the Third People's Hospital of Hefei from January 1, 2018 to May 31, 2019 were selected. They were divided into two groups according to EOS% in blood routine, with EOS% less than 2% as negative group (138 cases),and EOS% more than 2% as positive group (59 cases). We retrospectively analyzed the clinical characteristics, laboratory examinationresults, hospitalization time and glucocorticoid therapy responsiveness.Results The levels of chronic obstructive pulmonary disease assessment test (CAT), modified British Medical Research Council (mMRC), C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in the positive group were lower than those in the negative group. In the positive group, the grade Ⅱ distribution rate of globalinitiative for chronic obstructive lung disease (GOLD) was 40.7% (24/59), which was higher than 14.5% (20/138) in the negative group.Hospitalization days in the positive group was 10.9 (5-38) days, which was shorter than 13.6 (5/45) days in the negative group (P= 0.047). The level of glucocorticoids in the positive group is (181±200) mg, less than (351±301) mg in the negative group (P < 0.001). Inthe positive group, patients with the CAT score on the 7th day of treatment better than that on the day of admission (△CAT)≥2 accounted for 96.6% (57/59), which was higher than 80.4% (111/138) in the negative group (P =0.003). The patients with △CAT≥2 after glucocorticoids treatment in the positive group accounted for 95.9% (47/49), which was higher than 80.6% (104/129) in the negative group (P = 0.011).Conclusion Blood eosinophil levels in AECOPD can be used to predict the level of bacterial infection and the response of corticosteroids therapy. |
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