Page 53 - 南京医科大学学报自然科学版

第41卷第2期 南京医科大学学报（自然科学版）
2021年2月 Journal of Nanjing Medical University（Natural Sciences） ·203 ·

·临床研究·

嗜酸性粒细胞与慢性阻塞性肺病急性加重严重程度的关系

徐婷婷 ，宋伟伟 ，承璐潇 ，吉宁飞 ，黄 茂 1*
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南京医科大学第一附属医院呼吸与危重症医学科，老年科，江苏 南京 210029
1 2
［摘 要］ 目的：比较嗜酸性粒细胞炎症型慢性阻塞性肺病急性加重（eosinophilic⁃acute exacerbation of chronic obstructive pul⁃
monary disease，EOS⁃AECOPD）和非EOS⁃AECOPD患者基本临床情况和住院结局，指导早期精准治疗。方法：回顾性收集2017
年因慢性阻塞性肺病重度急性加重（acute exacerbation of chronic obstructive pulmonary disease，AECOPD）入住南京医科大学第
一附属医院患者的基本临床资料，比较EOS⁃AECOPD和非EOS⁃AECOPD两组患者的差异，分析影响患者病情的危险因素。结
果：EOS⁃AECOPD 患者63例（25.6%），非EOS⁃AECOPD 患者183例（74.4%），住院期间病情危重比例分别为17.5%和35.5%，死
亡比例分别为0和8.2%，（P＜0.05）。多元回归分析提示嗜酸性粒细胞（eosinophil，EOS）≥2%是患者病情严重程度的保护性因
素，肺心病、呼吸衰竭、中性粒淋巴细胞比值是患者病情严重程度的独立危险性因素（P＜0.05）。结论：非EOS⁃AECOPD患者
（EOS＜2%）病情较重、病死率高，临床上可根据EOS水平初步评估患者病情，指导危重患者的早期积极治疗。
［关键词］ 慢性阻塞性肺疾病；急性加重；嗜酸性粒细胞；病死率
［中图分类号］ R563 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）02⁃203⁃05
doi：10.7655/NYDXBNS20210209

Association of eosinophils and the severity of acute exacerbation of COPD
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XU Tingting ，SONG Weiwei ，CHENG Luxiao ，JI Ningfei ，HUANG Mao 1*
1 Department of Respiratory & Critical Care Medicine，Department of Geriatrics，the First Affiliated Hospital of
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Nanjing Medical University，Nanjing 210029，China
［Abstract］ Objective：The study compared the basic clinical information and hospitalization outcome of patients with eosinophil and
non⁃eosinophilic inflammation type of acute exacerbation of chronic obstructive pulmonary disease（COPD）in order to guide early and
accurate treatment. Methods：The basic clinical data of patients with severe acute exacerbation of COPD（AECOPD）admitted to the
First Affiliated Hospital of Nanjing Medical University during 2017 were collected to analyze the differences between EOS⁃AECOPD
and non⁃EOS⁃AECOPD groups as well as risk factors related to the condition. Results：There were 63 patients with EOS⁃AECOPD
（25.6%）and 183 patients with non ⁃ EOS ⁃ AECOPD（74.4%）. The proportion of critically ill patients was 17.5% and 35.5% ，
respectively. The mortality during hospitalization were 0 and 8.2%，respectively. Multi⁃regression analysis revealed that EOS ≥ 2% was
a protective factor for the severity of the disease，while pulmonary heart disease，respiratory failure and neutrophil to lymphocyte ratio
were independent risk factors. Conclusion：Patients with non ⁃ EOS AECOPD（PBE＜2%）are more severe，and mortality of
hospitalization is higher. The level of eosinophils may help to evaluate the severity of patients with AECOPD in clinical practice so as
to guide early and active treatment for critically ill patients.
［Key words］ chronic obstructive pulmonary disease；acute exacerbation；eosinophil；mortality
［J Nanjing Med Univ，2021，41（02）：203⁃206，211］

慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）简称慢阻肺，是全球常见慢性病及致
死的主要原因之一，产生巨大的经济负担 。2007年
［1］
钟南山等研究发现我国 40 岁以上 COPD 患病率为
［基金项目］ 国家自然科学基金面上项目（81770031）；江苏
省“科教强卫工程”青年医学人才项目（QNRC2016600） 8.2%，2018年王辰等进行中国成人肺健康研究表明
∗ 我国40岁以上成人COPD患病率为13.7%，患病总人
通信作者（Corresponding author），E⁃mail：hm6114@126.com