一个以美国人为基础的慢性阻塞性肺疾病队列的横断面研究中血嗜酸性粒细胞与临床特征的关系
2016/05/26
摘要
背景：目前的证据表明，血液中嗜酸性粒细胞（Eos）水平与慢性阻塞性肺疾病（COPD）治疗反应和自然史有关。这项研究分析了美国一个有代表性的肺功能证实的慢阻肺队列受试者的Eos水平和临床特征的关系。
方法：对来自于全国健康和营养调查（NHANES 2007-2010年）的超过40年肺功能定义的COPD受试者和Eos数据（N = 948）进行了横向数据分析。用卡方检验对Eos水平的临床特征差异（≤2%，>2%）进行比较。与Eos> 2%相关的特征采用多变量逻辑回归模型确定。对肺功能正常的受试者，再加上其他切入点的COPD人群的Eos > 2%的相关特征事后进行评估。
结果：大多数受试者Eos>2%；肺功能定义的COPD患者中有70.7%，肺功能正常者中有65.5%的Eos>2%。老龄人、男性、和目前有严重哮喘的COPD受试者明显与Eos > 2%相关。Eos ≤2%的 COPD组被报道有较高比率的心脏病和贫血。在肺功能正常的受试者中，Eos >2%与男性、超重/肥胖、高龄、枯草热、和充血性心力衰竭等相关。
解释：在基于美国的大队列中，EOS > 2%在COPD患者和肺功能正常的受试者中普遍存在。COPD患者中，EOS > 2%与某些特征相关，包括某些合并症的发生率降低；当然，我们需要进一步评估其临床意义和Eos水平、COPD机制，以及风险的相互关系。
（苏欣 审校）
Respir Med. 2016 Mar;112:88-96. doi:10.1016/j.rmed.2016.01.013.Epub 2016 Jan 22.
Relationship between blood eosinophils and clinical characteristics in a cross-sectional study of a US population-based COPD cohort.
DiSantostefano RL1, Hinds D2, Van Le H3, Barnes NC4.
Author information
Abstract
BACKGROUND:Current evidence suggests that blood eosinophil levels (Eos) are associated with chronic obstructive pulmonary disease (COPD) treatment response and natural history. This analysis investigated the relationship between Eos levels and clinical characteristics in a representative cohort of US subjects with spirometry-defined COPD.
METHODS:Cross-sectional data from the National Health And Nutrition Examination Survey (NHANES 2007-2010) of subjects ≥40 years with spirometry-defined COPD and Eos data (n = 948) were analyzed. Differences in clinical characteristics by Eos level (≤2%, >2%) were compared using chi-square tests. Characteristics associated with Eos >2% were identified using multivariate logistic regression modeling. Characteristics associated with Eos >2% among subjects with normal lung function, plus other cut-points among the COPD population, were evaluated post hoc.
FINDINGS:Most participants had Eos >2%; 70.7% with spirometry-defined COPD and 65.5% with normal lung function. Older age, male gender, and severe current asthma were significantly associated with Eos >2% in COPD subjects. The Eos ≤2% COPD group had higher reported rates of previous heart attack and anemia. Among participants with normal lung function, Eos >2% was associated with being male, being overweight/obese, older age, hay fever, and congestive heart failure.
INTERPRETATION:In this large US-based cohort, Eos >2% was prevalent in participants with COPD and normal lung function. Among participants with COPD, Eos >2% was associated with specific characteristics including lower rates of some co-morbidities; however, the clinical implications and relationships between Eos levels, COPD mechanisms, and risk of outcomes require further evaluation.Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.
KEYWORDS:Biomarkers; Chronic obstructive pulmonary disease; Eosinophils; NHANES
Respir Med. 2016 Mar;112:88-96. doi: 10.1016/j.rmed.2016.01.013. Epub 2016 Jan 22.
