外周血嗜酸性粒细胞水平与慢性阻塞性肺疾病急性加重期患者临床预后的相关性分析

目的　探讨外周血嗜酸性粒细胞（EOS）水平与慢性阻塞性肺疾病急性加重期（AECOPD）患者临床预后的关系。方法　选取2016 年9 月~ 2018 年12 月于锦州医科大学附属第一医院住院治疗的AECOPD 患者216 例为研究对象，根据入院时血细胞检测中EOS 百分比（EOS%）分为EOS 正常组（EOS% ≥ 2%）92 例和EOS 异常组（EOS% ＜ 2%）124 例，对比分析两组患者的临床资料，并于出院后随访至少1 年，以1 年内再发急性加重为主要研究终点，以因COPD 死亡为次要研究终点，采用Kaplan-Meier 生存曲线法比较两组患者1 年累积急性加重再发率及3 年累积生存率。结果　EOS正常组入院时C 反应蛋白、白细胞计数、中性粒细胞计数、住院期间激素使用总量、机械通气使用率、住院时间及住院费用均显著低于EOS 异常组，差异均有统计学意义（均P<0.05）。EOS 正常组1 年累积急性加重再发率为68.0%，低于EOS 异常组的84.1%，差异有统计学意义（χ2=19.566, P=0.000）；EOS 正常组3 年累积生存率为70.9%，高于EOS 异常组的41.8%，差异有统计学意义（χ2=9.925, P=0.002）。结论　外周血EOS 水平对预测AECOPD 患者的治疗效果及临床预后具有一定的参考价值。

Relationship between Peripheral Blood Eosinophil Level and the Prognosis ofPatients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective　To explore the relationship between peripheral blood eosinophil (EOS) level and the prognosis of patients withacute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods　216 patients with AECOPD who treated in theFirst Affiliated Hospital of Jinzhou Medical University were divided into two groups according to their admission eosinophil fractions(EOS%). Patients with EOS% ≥ 2% were in the EOS normal group (n=92), while patients with EOS%<2% were in the EOS abnormalgroup (n=124). The clinical data of the two groups were compared. Patients in both groups were followed up for at least 1 year afterdischarge. The main end point was acute exacerbation of COPD within 1 year, and the secondary end point was death due to COPD. The1 year acute exacerbation recurrence rate and 3 year survival rate between two groups were compared by Kaplan-meier survival curvemethod. Results　Compared with EOS abnormal group, patients in EOS normal group had lower levels of C-reactive protein, whiteblood cell count, neutrophils count, total hormone use during hospitalization, rate of mechanical ventilation, length of hospitalization,and hospitalization cost (all P<0.05). The 1 year acute exacerbation recurrence rate in EOS normal group was lower than those of EOSabnormal group (68.0% vs 84.1%, χ2=19.566，P=0.000) and the 3 year survival rate in EOS normal group was higher than those ofEOS abnormal group (70.9% vs 41.8%, χ2=9.925，P=0.002). Conclusion　The peripheral blood EOS levels are useful in predictingthe therapeutic effect and clinical prognosis of AECOPD patients.