Quantitative assessment of emphysema and bronchial wall thickness in patients with stable chronic obstructive pulmonary disease: comparison between the eosinophilic and non-eosinophilic phenotypes

Abstract Objective: To perform a quantitative assessment of bronchial wall thickening and the emphysema score in patients with stable chronic obstructive pulmonary disease (COPD), comparing the eosinophilic and non-eosinophilic COPD phenotypes. Materials and Methods: This was a retrospective observational study of patients with COPD followed between August 2018 and July 2019. The patients were divided into two groups by the eosinophil count in peripheral blood: eosinophilic (≥ 300 cells/µL); and non-eosinophilic (< 300 cells/µL). Quantitative, automated assessments of emphysema and bronchial wall thickness were performed by evaluating computed tomography scans of the chest. Results: We evaluated the records of 110 patients diagnosed with COPD: 28 (25.5%) in the eosinophilic group; and 82 (74.5%) in the non-eosinophilic group. The demographic, clinical, functional, and therapeutic variables were comparable between the two groups. There were no significant differences between the two groups in terms of the emphysema score or bronchial wall thickness (p > 0.05 for both). Conclusion: Patients with eosinophilic COPD do not appear to have lower emphysema scores or greater bronchial wall thickening than do those with non-eosinophilic phenotypes of the disease.

【摘要】
研究目的：对稳定期慢性阻塞性肺疾病（Chronic Obstructive Pulmonary Disease，COPD）患者的支气管壁增厚（bronchial wall thickening）及肺气肿评分（emphysema score）开展定量评估，对比嗜酸性粒细胞型与非嗜酸性粒细胞型COPD表型的差异。
材料与方法：本研究为回顾性观察性研究，纳入2018年8月至2019年7月期间随访的COPD患者。根据外周血嗜酸性粒细胞计数将患者分为两组：嗜酸性粒细胞型（≥300个/µL）与非嗜酸性粒细胞型（<300个/µL）。通过胸部计算机断层扫描（computed tomography，CT）影像，对肺气肿程度与支气管壁厚度进行自动化定量评估。
结果：本研究共纳入110例确诊COPD患者，其中嗜酸性粒细胞型组28例（占比25.5%），非嗜酸性粒细胞型组82例（占比74.5%）。两组患者的人口学特征、临床指标、肺功能参数及治疗相关变量均具有可比性。两组的肺气肿评分及支气管壁厚度均无显著统计学差异（二者p值均>0.05）。
结论：相较于非嗜酸性粒细胞型COPD患者，嗜酸性粒细胞型COPD患者的肺气肿评分并未更低，支气管壁增厚程度也未更显著。