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Clinical Differences between Eosinophilic and Noneosinophilic Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study
Mediators of Inflammation ( IF 4.6 ) Pub Date : 2020-11-12 , DOI: 10.1155/2020/1059079 Guangming Dai 1 , Yajuan Ran 2 , Jiajia Wang 3 , Xingru Chen 4 , Junnan Peng 4 , Xinglong Li 4 , Huojin Deng 5 , Min Xiao 6 , Tao Zhu 4
Mediators of Inflammation ( IF 4.6 ) Pub Date : 2020-11-12 , DOI: 10.1155/2020/1059079 Guangming Dai 1 , Yajuan Ran 2 , Jiajia Wang 3 , Xingru Chen 4 , Junnan Peng 4 , Xinglong Li 4 , Huojin Deng 5 , Min Xiao 6 , Tao Zhu 4
Affiliation
Rationale. Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is highly heterogeneous with a plethora of different etiologic factors and inflammatory presentations. COPD with higher blood eosinophil count is associated with increased readmission rates and better corticosteroid responses. However, the clinical features of eosinophilic AECOPD are not well explored. Thus, this study was aimed at exploring the clinical differences between eosinophilic and noneosinophilic AECOPD. Methods. A total of 643 AECOPD patients were enrolled in this multicenter cross-sectional study. Finally, 455 were included, 214 in the normal-eosinophil AECOPD (NEOS-AECOPD) group, 63 in the mild increased-eosinophil AECOPD (MEOS-AECOPD) group, and 138 in the severe increased-eosinophil AECOPD (SEOS-AECOPD) group. Demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistic regression analysis was performed to identify the independent factors associated with blood eosinophils (EOS). Correlations between blood EOS and its associated independent factors were evaluated. Results. The significant differences in 19 factors, including underlying diseases, clinical symptoms, and laboratory parameters, were identified by univariate analysis. Subsequently, multiple logistic regression analysis revealed that lymphocyte%, neutrophil% (NS%), procalcitonin (PCT), and anion gap (AG) were independently associated with blood EOS in AECOPD. Both blood EOS counts and EOS% were significantly correlated with lymphocyte%, NS%, PCT, and AG. Conclusions. Collectively, blood EOS was independently associated with lymphocyte%, NS%, PCT, and AG in AECOPD patients. Lymphocyte% was lower, and NS%, PCT, and AG were higher in eosinophilic AECOPD. Our results indicate that viral-dominant infections are the probable major etiologies of eosinophilic AECOPD. Noneosinophilic AECOPD is more likely associated with bacterial-dominant infections. The systemic inflammation in noneosinophilic AECOPD was more severe.
中文翻译:
嗜酸性粒细胞和非嗜酸性粒细胞慢性阻塞性肺疾病急性加重的临床差异:一项多中心横断面研究
基本原理。慢性阻塞性肺疾病急性加重 (AECOPD) 具有高度异质性,具有多种不同的病因和炎症表现。血液嗜酸性粒细胞计数较高的 COPD 与再入院率增加和皮质类固醇反应更好有关。然而,嗜酸性AECOPD的临床特征尚未得到很好的探索。因此,本研究旨在探讨嗜酸性和非嗜酸性 AECOPD 的临床差异。方法. 共有 643 名 AECOPD 患者参加了这项多中心横断面研究。最终纳入 455 人,其中嗜酸性粒细胞正常 AECOPD (NEOS-AECOPD) 组 214 人,嗜酸性粒细胞轻度升高 AECOPD (MEOS-AECOPD) 组 63 人,嗜酸性粒细胞严重升高 AECOPD (SEOS-AECOPD) 组 138 人. 收集了人口统计数据、基础疾病、症状和实验室检查结果。进行多元逻辑回归分析以确定与血嗜酸性粒细胞(EOS)相关的独立因素。评估了血液 EOS 与其相关独立因素之间的相关性。结果. 通过单因素分析确定基础疾病、临床症状、实验室参数等19个因素的显着差异。随后,多元逻辑回归分析显示淋巴细胞百分比、中性粒细胞百分比 (NS%)、降钙素原 (PCT) 和阴离子间隙 (AG) 与 AECOPD 中的血液 EOS 独立相关。血液 EOS 计数和 EOS% 均与淋巴细胞百分比、NS%、PCT 和 AG 显着相关。结论. 总的来说,血液 EOS 与 AECOPD 患者的淋巴细胞百分比、NS%、PCT 和 AG 独立相关。嗜酸性AECOPD中淋巴细胞百分比较低,NS%、PCT和AG较高。我们的研究结果表明,以病毒为主的感染可能是嗜酸性粒细胞 AECOPD 的主要病因。非嗜酸性 AECOPD 更可能与细菌为主的感染有关。非嗜酸性 AECOPD 的全身炎症更严重。
更新日期:2020-11-12
中文翻译:
嗜酸性粒细胞和非嗜酸性粒细胞慢性阻塞性肺疾病急性加重的临床差异:一项多中心横断面研究
基本原理。慢性阻塞性肺疾病急性加重 (AECOPD) 具有高度异质性,具有多种不同的病因和炎症表现。血液嗜酸性粒细胞计数较高的 COPD 与再入院率增加和皮质类固醇反应更好有关。然而,嗜酸性AECOPD的临床特征尚未得到很好的探索。因此,本研究旨在探讨嗜酸性和非嗜酸性 AECOPD 的临床差异。方法. 共有 643 名 AECOPD 患者参加了这项多中心横断面研究。最终纳入 455 人,其中嗜酸性粒细胞正常 AECOPD (NEOS-AECOPD) 组 214 人,嗜酸性粒细胞轻度升高 AECOPD (MEOS-AECOPD) 组 63 人,嗜酸性粒细胞严重升高 AECOPD (SEOS-AECOPD) 组 138 人. 收集了人口统计数据、基础疾病、症状和实验室检查结果。进行多元逻辑回归分析以确定与血嗜酸性粒细胞(EOS)相关的独立因素。评估了血液 EOS 与其相关独立因素之间的相关性。结果. 通过单因素分析确定基础疾病、临床症状、实验室参数等19个因素的显着差异。随后,多元逻辑回归分析显示淋巴细胞百分比、中性粒细胞百分比 (NS%)、降钙素原 (PCT) 和阴离子间隙 (AG) 与 AECOPD 中的血液 EOS 独立相关。血液 EOS 计数和 EOS% 均与淋巴细胞百分比、NS%、PCT 和 AG 显着相关。结论. 总的来说,血液 EOS 与 AECOPD 患者的淋巴细胞百分比、NS%、PCT 和 AG 独立相关。嗜酸性AECOPD中淋巴细胞百分比较低,NS%、PCT和AG较高。我们的研究结果表明,以病毒为主的感染可能是嗜酸性粒细胞 AECOPD 的主要病因。非嗜酸性 AECOPD 更可能与细菌为主的感染有关。非嗜酸性 AECOPD 的全身炎症更严重。