| 李小红,沈晓飞,闫雪.慢性阻塞性肺疾病急性加重期的中医证型结合嗜酸性粒细胞分层的临床意义[J].浙江中医药大学学报,2021,45(9):1013-1017, 1021. |
| 慢性阻塞性肺疾病急性加重期的中医证型结合嗜酸性粒细胞分层的临床意义 |
| Clinical Significance of Traditional Chinese Medicine Syndrome Type Combined with Eosinophil Stratification in Acute Exacerbation of Chronic Obstructive Pulmonary Disease |
| DOI：10.16466/j.issn1005-5509.2021.09.014 |
| 中文关键词: 慢性阻塞性肺疾病急性加重期 中医辨证分型 嗜酸性粒细胞 生物标志物 异质性 病因识别 表型 预后 |
| 英文关键词: acute exacerbation of chronic obstructive pulmonary disease TCM syndrome differentiation eosinophils biomarker heterogeneity etiological identification phenotype prognosis |
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| [目的]探讨慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease，AECOPD)的中医证型与外周血嗜酸性粒细胞(eosinophil，EOS)分层的关系及临床意义。[方法]回顾性分析了226例AECOPD住院患者的临床资料，进行中医辨证分型，结合外周血EOS分层，观察比较各组炎症指标白细胞(white blood cell，WBC)计数和超敏C反应蛋白(hypersensitive-C reactive protein，hs-CRP)水平、平均住院天数以及再次入院风险各项指标的差别。[结果]痰浊阻肺证和痰热壅肺证外周血EOS≥300个/μL者的比例高于风寒袭肺证，差异有统计学意义(P＜0.05)。三种证型外周血EOS≥300个/μL者的WBC和hs-CRP、平均住院天数明显低于同证型EOS＜300个/μL的患者，差异有统计学意义(P＜0.05，P＜0.01)。痰热壅肺证和风寒袭肺证EOS≥300个/μL的患者再次入院比例低于同证型EOS＜300个/μL者，差异有统计学意义(P＜0.01，P＜0.05)，而痰浊阻肺证EOS≥300个/μL的患者的再次入院比例高于同证型EOS＜300个/μL的患者，差异有统计学意义(P＜0.01)。[结论]不同外周血EOS水平的AECOPD患者在三种证型中的分布有一定规律，痰浊阻肺证和痰热壅肺证外周血EOS≥300个/μL的患者比例高于风寒袭肺证；外周血EOS可以在一定程度上预判三种证型患者的住院时间、治疗反应以及再次入院风险。 |
| 英文摘要: |
| [Objective]To explore the relationship between traditional Chinese medicine(TCM) syndrome types of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) and eosinophil(EOS) counts stratification and its clinical significance.[Methods]The clinical data of 226 patients with AECOPD were retrospectively analysed， and the TCM syndrome types were classified. Combined with the EOS counts stratification of peripheral blood， the differences of inflammatory indexes hypersensitive-C reactive protein(hs-CRP) and white blood cell(WBC)， average length of stay and re-admission risk were analysed.[Results] The proportion of patients with high EOS counts(≥300 cells/μL) in phlegm turbidity obstructing lung syndrome and phlegm heat obstructing lung syndrome groups was higher than that of patients with wind cold attacking lung syndrome(P＜0.05). The WBC and hs-CRP of the three types of blood EOS counts≥300 cells/μL and the average length of stay were significantly lower than those of the same type of EOS counts＜300 cells/μL(P＜0.05，P＜0.01). The re-admission rate of patients with phlegm heat obstructing lung syndrome and wind cold attacking lung syndrome with EOS counts≥300 cells/μL was lower than that of patients with the same syndrome type EOS counts＜300 cells/μL(P＜0.01，P＜0.05). The rate of re-admission of AECOPD patients with phlegm turbidity obstructing lung syndrome with EOS counts≥300 cells/μL was higher than that of patients with the same type of EOS counts＜300 cells/μL(P＜0.01). [Conclusion]There is a certain pattern in the distribution of peripheral blood EOS counts and TCM syndrome types in AECOPD patients.The proportion of patients with phlegm turbidity obstructing lung syndrome and phlegm heat obstructing lung syndrome with blood EOS counts≥300 cells/μL is higher than the proportion of patients with wind cold attacking lung syndrome.Peripheral blood EOS counts can predict the hospital stay， treatment response and risk of re-admission of patients with the three syndromes to a certain extent. |
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