慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞比例、血清IL-5水平与肺功能的相关性

doi:10.20223/j.cnki.1000-8535.2025.12.010

摘要/Abstract

摘要： 目的探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞（EOS）、血清白细胞介素-5（IL-5）水平与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积与用力肺活量的比值（FEV₁/FVC）、用力肺活量（FVC）的相关性。方法纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者,以2%作为外周血EOS比例（EOS%）截断值分为两组,研究组（EOS%≥2%）34例,对照组（EOS%<2%）39例,收集两组患者的一般临床资料、实验室检查结果、肺功能检查结果（FEV₁、FVC、FEV₁/FVC）,比较组间差异,分析指标间的相关性。结果对照组与实验组患者EOS%分别为0.5（0.1,0.9）%、5.15（2.60,10.05）%,两组患者EOS%差异有统计学意义（P<0.05）。对照组与实验组患者IL-5水平分别为0.98（0.56,1.78）ng/L、3.6（1.73,6.77）ng/L,两组IL-5水平差异有统计学意义（P<0.05）。对照组FEV₁（L）、FVC（L）、FEV₁/FVC水平分别为1.32（1.18,1.58）、2.07（1.92,2.62）、0.62（0.57,0.67）;实验组分别为1.24（1.00,1.52）、2.22（1.94,2.56）、0.58（0.47,0.67）,两组FEV₁、FVC、FEV₁/FVC水平差异均无统计学意义（P>0.05）。Spearman等级相关检验结果显示,EOS%与IL-5水平呈正相关（r_s=0.870,P<0.001）;按组别进行分层后结果显示,对照组、试验组EOS%与IL-5水平均呈正相关（r_s=0.820,P<0.001;r_s=0.938,P<0.001）。EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P<0.05）,与FVC不相关（r_s=0.039,P>0.05）。对照组EOS%、IL-5水平与FEV₁、FEV₁/FVC、FVC不相关（P>0.05）;实验组EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P<0.05）,与FVC不相关（P>0.05）。结论慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关,外周血EOS%≥2%时血EOS%、血清IL-5与FEV₁、FEV₁/FVC呈负相关,与FVC无关。

关键词: 慢性阻塞性肺疾病, 血嗜酸性粒细胞, IL-5, 肺功能

Abstract: Objective To explore the correlation among blood eosinophil levels,serum interleukin-5（IL-5）levels,and forced expiratory volume in one second（FEV₁）,the ratio of forced expiratory volume in one second to forced vital capacity（FEV₁/FVC）,and forced vital capacity（FVC）during the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods From March 2023 to March 2024,73 patients hospitalized for AECOPD at Shunde District Fifth People's Hospital of Foshan City were included,and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophils（EOS%）．The experimental group（EOS%≥2%）included 34 patients,while the control group（EOS%<2%）included 39 patients．General clinical data,laboratory test results,and pulmonary function test results（FEV₁,FVC,FEV₁/FVC）were collected from both groups．Results The median quartiles of EOS% for the control group and experimental group were 0.5（0.1,0.9）% and 5.15（2.60,10.05）%,respectively．There was a statistically significant difference between the EOS% of two groups（P<0.05）．The median quartiles of IL-5 levels for the control group and experimental group were 0.98（0.56,1.78）ng/L and 3.6（1.73,6.77）ng/L,respectively．There was also a statistically significant difference in IL-5 levels between the two groups（P<0.05）．For the control group,the median quartiles of FEV₁,FVC,and FEV₁/FVC were 1.32（1.18,1.58）,2.07（1.92,2.62）and 0.62（0.57,0.67）,respectively．For the experimental group,they were 1.24（1.00,1.52）,2.22（1.94,2.56）and 0.58（0.47,0.67）,respectively．There was no statistically significant difference between the two groups in FEV₁,FVC and FEV₁/FVC levels（P<0.05）．Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level （r_s=0.870,P<0.001）．Stratified by group,both the control and experimental groups showed a positive correlation between EOS% and IL-5 level （r_s=0.820,P<0.001;r_s=0.938,P<0.001）．There was a negative correlation between EOS%,IL-5 level,and FEV₁,FEV₁/FVC（P<0.05）,but no correlation with FVC（P>0.05）．In the control group,there was no correlation between EOS%,IL-5 level,and FEV₁,FEV₁/FVC,or FVC（P>0.05）．In the experimental group,there was a negative correlation between EOS%,IL-5 level,and FEV₁,FEV₁/FVC（P<0.05）,but no correlation with FVC（P>0.05）．Conclusions During AECOPD,blood EOS% is positively correlated with serum IL-5 levels．When peripheral blood eosinophils are ≥2%,blood EOS%,serum IL-5,and FEV₁,FEV₁/FVC are negatively correlated,while there is no correlation with FVC．

Key words: chronic obstructive pulmonary disease, eosinophils in blood, IL-5, lung function

张惠群, 张显风, 梅洁萍, 曹扬双, 甘兵. 慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞比例、血清IL-5水平与肺功能的相关性[J]. 广州医药, 2025, 56(12): 1684-1692.

ZHANG Huiqun, ZHANG Xianfeng, MEI Jieping, CAO Yangshuang, GAN Bing. Correlation between blood eosinophils ratio,serum IL-5 levels,and pulmonary function during acute exacerbation of chronic obstructive pulmonary disease[J]. Guangzhou Medical Journal, 2025, 56(12): 1684-1692.

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