外周血嗜酸性粒细胞水平对慢性阻塞性肺病急性加重病人炎症程度和病程评估的临床价值

Clinical Value of Peripheral Blood Eosinophil Level in Evaluation of Inflammation Degree and Disease Course in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

摘要: 目的：探讨外周血嗜酸性粒细胞(EOS)水平对慢性阻塞性肺病急性加重(AECOPD)病人的炎症反应程度、病情转归以及临床应用价值。方法：纳入2023年3月至2024年1月在青岛大学附属医院西海岸院区呼吸与危重症医学科住院治疗的120名AECOPD病人，依据纳入病人入院后24小时内所做血常规的嗜酸性粒细胞比例水平分为2组。I组为高水平嗜酸性粒细胞组(EOS ≥ 2%)，共57例，II组为低水平嗜酸性粒细胞组(EOS < 2%)，共63例，比较两组病人的一般资料、实验室指标、住院天数等指标。结果：两组病人的一般资料性别、年龄、吸烟史、合并症(高血压、糖尿病)、BMI无统计学差异(P > 0.05)；EOS < 2%组的病人住院天数、白蛋白、中性粒细胞计数、单核细胞计数，白细胞计数、中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)均明显高于EOS ≥ 2%组的病人，差异有统计学意义(P < 0.05)；两组病人的血红蛋白、淋巴细胞计数、红细胞分布宽度(RDW)，血小板计数，3个月内有无非计划再入院比较无统计学意义(P < 0.05)。所纳入病人的EOS水平与NLR、PLR呈显著负相关。结论：EOS水平对判断AECOPD病人的病情严重程度，炎症反应程度，病程长短有一定参考意义。

Abstract: Objective: To investigate the inflammatory response degree, disease outcome and clinical application value of peripheral blood eosinophil (EOS) level in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: A total of 120 AECOPD patients hospitalized in the Department of Respiratory and Critical Care Medicine of the West Coast Branch of the Affiliated Hospital of Qingdao University from March 2023 to January 2024 were enrolled, and they were divided into 2 groups according to the eosinophil ratio level of blood routine done within 24 hours after admission. Group I was high level eosinophil group (EOS ≥ 2%), with a total of 57 cases, and group II was low level eosinophil group (EOS < 2%), with a total of 63 cases. The general data, laboratory indicators, hospitalization days and other indicators of the two groups were compared. Result: There were no statistically significant differences in gender, age, smoking history, comorbidities (hypertension, diabetes) and BMI between the two groups (P > 0.05). The hospitalization days, albumin, neutrophil count, monocyte count, white blood cell count, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) of patients in the EOS < 2% group were significantly higher than those in the EOS ≥ 2% group, with statistically significant differences (P < 0.05). There was no significant difference in hemoglobin, lymphocyte count, red cell distribution width (RDW), platelet count, and unplanned readmission within 3 months between the two groups (P < 0.05). The EOS level of the patients was significantly negatively correlated with NLR and PLR. Conclusion: The EOS level has certain reference significance in judging the severity, degree of inflammation, and duration of AECOPD patients.