摘要
目的 探讨诱导痰细胞学检查在慢性阻塞性肺疾病急性加重期患者诊疗中的应用价值。方法 采用前瞻性横断面研究方法,按照筛选标准选取梅州市人民医院2023年11月1日至2024年8月31日住院的慢阻肺急性加重期患者98例,收集基线资料,完善诱导痰细胞学检查和相关临床检查项目。以诱导痰细胞学检查将患者分为单纯中性粒细胞为主型、单纯嗜酸性粒细胞为主型、混合型和其他类型。比较四组患者的临床特征和检验结果,分析诱导痰细胞分类与患者评分、临床检查指标的相关性。结果 单纯中性粒细胞为主型组患者有61例,占比62.24%;四组患者的基本情况和相关评分结果的差异无统计学意义;四组患者血常规中的中性粒细胞比例和嗜酸性粒细胞比例的差异有统计学意义,其中单纯中性粒细胞为主型组和混合型组AECOPD患者的血常规中的中性粒细胞比例分别为(75.28±10.17)%、(78.26±8.90)%高于单纯嗜酸性粒细胞为主型组(65.60±8.95)%,单纯嗜酸性粒细胞为主型AECOPD患者的血常规中的嗜酸性粒细胞比例(%)为9.1(4.55,16.15)高于其他三组(P<0.05);诱导痰中性粒细胞比例与血常规中的白细胞和中性粒细胞比例、CRP、IL-6呈显著正相关,而与血常规中的嗜酸性粒细胞比例、动脉血气分析中的PaO_(2)、FEV1/FVC呈显著负相关性(P<0.05)。结论 AECOPD患者的诱导痰细胞分类以中性粒细胞比例升高为主,诱导痰中性粒细胞可以反映AECOPD患者的气道炎症情况及基础肺功能状态,诱导痰细胞学检查对AECOPD患者的临床诊疗有指导意义。
Objective To investigate the clinical utility of induced sputum cytology in the diagnosis and treatment of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A prospective cross-sectional study was conducted,enrolling 98 hospitalized AECOPD patients at Meizhou People’s Hospital from November 2023 to August 2024,based on predefined inclusion criteria.Baseline data were collected,and induced sputum cytology along with relevant clinical tests was performed.Patients were categorized into four groups based on induced sputum cytology:neutrophil-predominant,eosinophil-predominant,mixed,and other types.Clinical characteristics and laboratory results were compared among the groups,and correlations between sputum cell classification and clinical scores,and laboratory indicators were analyzed.Results There were 61 patients in the group mainly composed of neutrophils,accounting for 62.24%.There was no statistically significant difference in basic information and related rating results among the four groups of patients.There was a statistically significant difference in the proportion of neutrophils and eosinophils in the blood routine of the four groups of patients.Among them,the proportion of neutrophils in the blood routine of AECOPD patients in the pure neutrophil dominant group(75.28±10.17)%and mixed group(78.26±8.90)%was higher than that in the pure eosinophil dominant group(65.60±8.95)%.The proportion of eosinophils in the blood routine of AECOPD patients in the pure eosinophil dominant group(9.1%[4.55,16.15])was higher than that in the other three groups,with P<0.05.The proportion of induced sputum neutrophils was significantly positively correlated with the proportion of white blood cells and neutrophils, CRP, IL-6 in blood routine, while significantly negatively correlated with the proportion of eosinophils in blood routine, PaO_(2) in arterial blood gas analysis, and FEV 1/FVC, with P <0.05. Conclusion The classification of induced sputum cells in AECOPD patients is mainly characterized by an increase in the proportion of neutrophils. Induced sputum neutrophils can reflect the airway inflammation and basic lung function status of AECOPD patients. Induced sputum cytology examination has guiding significance for the clinical diagnosis and treatment of AECOPD patients.
作者
温雅
黄洁玉
石晓雁
曾梓雄
杜焰家
WEN Ya;HUANG Jieyu;SHI Xiaoyan;ZENG Zixiong;DU Yanjia(Department of Pulmonary and Critical Care Medicine,Meizhou People′s Hospital,Meizhou,Guangdong 514000,China)
出处
《临床肺科杂志》
2025年第7期1028-1033,1039,共7页
Journal of Clinical Pulmonary Medicine
基金
梅州市社会发展科技计划项目(2023C0301163/2023B43)。
关键词
诱导痰
慢性阻塞性肺疾病
中性粒细胞
嗜酸性粒细胞
肺功能
induced sputum
chronic obstructive pulmonary disease
neutrophil
eosinophil granulocyte
lung function
