천식발작 환자에서 말초혈액 내 호산구와 호중구 증가의 임상적 의의
Clinical Significance of Blood Eosinophilia and Neutrophilia in Patients with Acute Asthma
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Background: Neutrophilic airway inflammation has been reported in severe intractable asthma. Therefore, direct assessment of airway inflammation may be useful. However, but it is not easy especially in patients with acute asthma. Objective: To investigate whether the clinical characteristics of patients with acute asthma differ according to the cellular profiles of their blood samples which are easily obtainable. Method: The medical records of 410 adult patients with acute asthma, who were hospitalized between 2002 and 2007, were reviewed. Blood eosinophilia and neutrophilia were defined as the cell counts of ≥450/μL and ≥7,500/μL, respectively. Result: The patients with eosinophilia were relatively young,and they had high serum levels of total IgE and posttreatment lung function. The patients with neutrophilia showed a significantly lower posttreatment lung function and a higher prevalence of emphysema than those with eosinophilia. The levels of PaCO2 were significantly related to the eosinophil counts, while the levels of PaO2 and C- reactive protein (CRP) were related to the neutrophil counts (all P<0.01). Conclusion: Eosinophilic or neutrophilic response in peripheral blood which occur in acute asthma patients may depend on upon the attack severity and clinical characteristics of subjects such as allergy or irreversible airflow obstruction. (Korean J Asthma Allergy Clin Immunol 2008;28:184-191)
Abstract
Background: Neutrophilic airway inflammation has been reported in severe intractable asthma. Therefore, direct assessment of airway inflammation may be useful. However, but it is not easy especially in patients with acute asthma. Objective: To investigate whether the clinical characteristics of patients with acute asthma differ according to the cellular profiles of their blood samples which are easily obtainable. Method: The medical records of 410 adult patients with acute asthma, who were hospitalized between 2002 and 2007, were reviewed. Blood eosinophilia and neutrophilia were defined as the cell counts of ≥450/μL and ≥7,500/μL, respectively. Result: The patients with eosinophilia were relatively young,and they had high serum levels of total IgE and posttreatment lung function. The patients with neutrophilia showed a significantly lower posttreatment lung function and a higher prevalence of emphysema than those with eosinophilia. The levels of PaCO2 were significantly related to the eosinophil counts, while the levels of PaO2 and C- reactive protein (CRP) were related to the neutrophil counts (all P<0.01). Conclusion: Eosinophilic or neutrophilic response in peripheral blood which occur in acute asthma patients may depend on upon the attack severity and clinical characteristics of subjects such as allergy or irreversible airflow obstruction. (Korean J Asthma Allergy Clin Immunol 2008;28:184-191)
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