| 魏霞,李洁,丁琦,许淑娣,米九运,任京婷,李瑞丽,姚静,金晨旺,郭佑民.伴嗜酸性粒细胞增高的慢性阻塞性肺疾病急性加重期的肺功能及影像特征[J].中国医学影像技术,2020,36(3): |
| 伴嗜酸性粒细胞增高的慢性阻塞性肺疾病急性加重期的肺功能及影像特征 |
| Pulmonary function and imaging characteristics of acute exacerbation of chronic obstructive pulmonary disease with elevated eosinophils |
| 投稿时间：2020-01-15 修订日期：2020-03-23 |
| DOI： |
| 中文关键词: 慢性阻塞性肺疾病，嗜酸性粒细胞，肺功能，CT |
| 英文关键词:COPD, eosinophils, lung function, CT |
| 基金项目:空 |
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| 中文摘要: |
| 目的：通过对外周血嗜酸性粒细胞≥300/ul和＜300/ul的慢性阻塞性肺疾病急性加重期（AECOPD）两组患者的临床、炎症标记物、传统肺功能和脉冲振荡阻力测定（IOS）参数，以及容积CT参数特征的分析，探讨两组人群的特征性差异，为治疗提供策略性指导。方法：纳入357例AECOPD，其中EOS≥300/ul组41例，EOS＜300/ul组组316例，比较CAT评分、mMRC评定等临床指标炎症指标；传统肺功能IOS指标，肺容积、肺气肿指数、肺气肿密度等影像学参数。结果：①与EOS＜300/ul比较，EOS≥300/ul的AECOPD组的中性粒细胞比率偏低（64.7% VS 73%，p＜0.001）；FIB偏低（3.59 VS 3.97，p=0.031）；CRP偏低（3.3mg/L VS 8.63 mg/L，p=0.012）；吸烟量较低（25包年 VS 40包年，p=0.009）；②与EOS＜300/ul比较，EOS≥300/ul组的RV/TLC偏低（51.91% VS 57.44%，p=0.041）； R5和R5%pred更高（R5为0.56 vs 0.49, p=0.036; R5%pred为178.65% vs 155.7%, p=0.027）；③与EOS＜300/ul比较，EOS≥300/ul的AECOPD组的全肺，右肺和左肺的肺气肿平均密度和PD15更高，提示EOS＜300/ul组肺实质破坏更严重（p＜0.05）。结论：EOS≥300/ul的AECOPD组具有更明显的气道阻力增加，肺气肿损害程度较EOS＜300/ul的AECOPD组轻微。 |
| 英文摘要: |
| objection: Through the analysis of clinical, inflammatory markers, two type of pulmonary function tests and volume CT parameters of two groups of AECOPD with peripheral blood eosinophils (EOS) ≥300 / ul and EOS<300 / ul explore the characteristic differences ,and provide strategic guidance for treatment. Methods: A total of 357 cases of AECOPD were included, including 41 cases in the EOS≥300 / ul group and 316 cases in the EOS<300 / ul group, and compared with clinical indicators such as CAT score and mMRC assessment; inflammation indicators ; traditional lung functions and and IOS indicators, lung volume, emphysema index, emphysema density and other imaging parameters. Results: compared with EOS<300/ul, AECOPD group with EOS≥300/ul had a lower neutrophils ratio (64.7% VS 73%, p<0.001), lower FIB (3.59 VS 3.97, p=0.031); lower CRP (3.3 mg/L VS 8.63 mg/L, p=0.012), lower smoking number (25 pack years VS 40 pack years, p=0.009); lower RV/TLC (51.91 % VS 57.44%, p=0.041); higher R5 and R5%pred, (R5 was 0.56 VS 0.49, p=0.036; R5%pred was 178.65% VS 155.7%, p=0.027); higher mean pulmonary emphysema density and PD15 in the whole lung, right lung and left lung, suggesting that EOS<300/ul group had more serious pulmonary parenchymal destruction (p<0.05).Conclusion: the AECOPD group with EOS≥300/ul had more significant pulmonary function impairment due to increased airway resistance, and emphysema was less severe than the AECOPD group with EOS < 300/ul. |
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