{"title":"海拔和嗜酸性粒细胞与慢性阻塞性肺疾病急性加重期一年死亡率的关系：一项队列研究","authors":"Junqing Li, Zhangchun He, Chengyue Zhu, Rongrong Li, Zixuan Zheng, Hanwei Zhao, Yue Dong, Zhijun Jie, Heyuan Ding, Jindong Shi","doi":"10.1186/s12890-025-03832-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Altitude and eosinophil (EOS) are closely related to chronic obstructive pulmonary disease (COPD). There are limited studies on the association of altitude and EOS with mortality of COPD patients. Our aim was to explore the association of altitude and EOS with one-year all-cause mortality of patients hospitalized for acute exacerbation of COPD (AECOPD).</p><p><strong>Methods: </strong>A total of 351 inpatients with AECOPD in two hospitals from 2021 to 2022 were enrolled and divided into two groups based on the altitude and followed up for one year. Logistic and Cox regression analyses were used to determine the relationship of altitude and eosinophil with one-year all-cause mortality. Restricted cubic spline (RCS) was used to investigate the relationship between variables and outcome. In addition, a post hoc analysis was conducted to explore the relationship between EOS and one-year mortality of AECOPD patients at high altitude.</p><p><strong>Results: </strong>Patients at high altitude had a higher one-year all-cause mortality compared with patients at low altitude (P = 0.001). Multivariate COX regression showed that altitude (HR 3.03, 95% CI 1.22-7.54, P = 0.017), age (HR 2.77, 95% CI 1.31-5.88, P = 0.008) and CRP (HR 2.62, 95% CI 1.29-5.29, P = 0.007) increased the mortality risk in AECOPD patients. BMI (HR 0.34, 95% CI 0.15-0.78, P = 0.011) and EOS (HR 0.16, 95% CI 0.04-0.68, P = 0.013) decreased the mortality risk in AECOPD patients. Age, BMI, EOS and CRP were linearly correlated with one-year mortality of AECOPD. A post hoc analysis revealed that EOS (HR 0.17, 95% CI 0.04-0.70, P = 0.014) decreased the mortality risk in AECOPD patients at high altitude.</p><p><strong>Conclusion: </strong>Patients with COPD at high altitude had a higher one-year mortality. Altitude and EOS are associated with one-year mortality in COPD patients, which underscores the potential therapeutic benefits of EOS in mitigating the mortality risk of AECOPD patients at high altitude.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"362"},"PeriodicalIF":2.8000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308960/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of altitude and eosinophil with the one-year mortality of acute exacerbation of chronic obstructive pulmonary disease: a cohort study.\",\"authors\":\"Junqing Li, Zhangchun He, Chengyue Zhu, Rongrong Li, Zixuan Zheng, Hanwei Zhao, Yue Dong, Zhijun Jie, Heyuan Ding, Jindong Shi\",\"doi\":\"10.1186/s12890-025-03832-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Altitude and eosinophil (EOS) are closely related to chronic obstructive pulmonary disease (COPD). There are limited studies on the association of altitude and EOS with mortality of COPD patients. Our aim was to explore the association of altitude and EOS with one-year all-cause mortality of patients hospitalized for acute exacerbation of COPD (AECOPD).</p><p><strong>Methods: </strong>A total of 351 inpatients with AECOPD in two hospitals from 2021 to 2022 were enrolled and divided into two groups based on the altitude and followed up for one year. Logistic and Cox regression analyses were used to determine the relationship of altitude and eosinophil with one-year all-cause mortality. Restricted cubic spline (RCS) was used to investigate the relationship between variables and outcome. In addition, a post hoc analysis was conducted to explore the relationship between EOS and one-year mortality of AECOPD patients at high altitude.</p><p><strong>Results: </strong>Patients at high altitude had a higher one-year all-cause mortality compared with patients at low altitude (P = 0.001). Multivariate COX regression showed that altitude (HR 3.03, 95% CI 1.22-7.54, P = 0.017), age (HR 2.77, 95% CI 1.31-5.88, P = 0.008) and CRP (HR 2.62, 95% CI 1.29-5.29, P = 0.007) increased the mortality risk in AECOPD patients. BMI (HR 0.34, 95% CI 0.15-0.78, P = 0.011) and EOS (HR 0.16, 95% CI 0.04-0.68, P = 0.013) decreased the mortality risk in AECOPD patients. Age, BMI, EOS and CRP were linearly correlated with one-year mortality of AECOPD. A post hoc analysis revealed that EOS (HR 0.17, 95% CI 0.04-0.70, P = 0.014) decreased the mortality risk in AECOPD patients at high altitude.</p><p><strong>Conclusion: </strong>Patients with COPD at high altitude had a higher one-year mortality. Altitude and EOS are associated with one-year mortality in COPD patients, which underscores the potential therapeutic benefits of EOS in mitigating the mortality risk of AECOPD patients at high altitude.</p>\",\"PeriodicalId\":9148,\"journal\":{\"name\":\"BMC Pulmonary Medicine\",\"volume\":\"25 1\",\"pages\":\"362\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-07-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308960/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Pulmonary Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12890-025-03832-5\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pulmonary Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12890-025-03832-5","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0
摘要
背景：海拔和嗜酸性粒细胞（EOS）与慢性阻塞性肺疾病（COPD）密切相关。关于海拔和EOS与COPD患者死亡率之间关系的研究有限。我们的目的是探讨海拔和EOS与慢性阻塞性肺病急性加重（AECOPD）住院患者一年全因死亡率的关系。方法：选取两家医院2021 - 2022年AECOPD住院患者351例，按海拔分为两组，随访1年。采用Logistic和Cox回归分析确定海拔和嗜酸性粒细胞与一年全因死亡率的关系。采用限制性三次样条（RCS）研究变量与结果之间的关系。此外，我们还进行了事后分析，探讨EOS与高原AECOPD患者1年死亡率之间的关系。结果：高海拔地区患者一年的全因死亡率高于低海拔地区患者（P = 0.001）。多因素COX回归显示，海拔（HR 3.03, 95% CI 1.22 ~ 7.54, P = 0.017）、年龄（HR 2.77, 95% CI 1.31 ~ 5.88, P = 0.008）和CRP （HR 2.62, 95% CI 1.29 ~ 5.29, P = 0.007）增加了AECOPD患者的死亡风险。BMI （HR 0.34, 95% CI 0.15 ~ 0.78, P = 0.011）和EOS （HR 0.16, 95% CI 0.04 ~ 0.68, P = 0.013）降低了AECOPD患者的死亡风险。年龄、BMI、EOS、CRP与AECOPD 1年死亡率呈线性相关。事后分析显示，EOS （HR 0.17, 95% CI 0.04-0.70, P = 0.014）降低了高海拔地区AECOPD患者的死亡风险。结论：高原地区COPD患者一年死亡率较高。海拔和EOS与COPD患者一年死亡率相关，这强调了EOS在降低高海拔AECOPD患者死亡风险方面的潜在治疗益处。
Association of altitude and eosinophil with the one-year mortality of acute exacerbation of chronic obstructive pulmonary disease: a cohort study.
Background: Altitude and eosinophil (EOS) are closely related to chronic obstructive pulmonary disease (COPD). There are limited studies on the association of altitude and EOS with mortality of COPD patients. Our aim was to explore the association of altitude and EOS with one-year all-cause mortality of patients hospitalized for acute exacerbation of COPD (AECOPD).
Methods: A total of 351 inpatients with AECOPD in two hospitals from 2021 to 2022 were enrolled and divided into two groups based on the altitude and followed up for one year. Logistic and Cox regression analyses were used to determine the relationship of altitude and eosinophil with one-year all-cause mortality. Restricted cubic spline (RCS) was used to investigate the relationship between variables and outcome. In addition, a post hoc analysis was conducted to explore the relationship between EOS and one-year mortality of AECOPD patients at high altitude.
Results: Patients at high altitude had a higher one-year all-cause mortality compared with patients at low altitude (P = 0.001). Multivariate COX regression showed that altitude (HR 3.03, 95% CI 1.22-7.54, P = 0.017), age (HR 2.77, 95% CI 1.31-5.88, P = 0.008) and CRP (HR 2.62, 95% CI 1.29-5.29, P = 0.007) increased the mortality risk in AECOPD patients. BMI (HR 0.34, 95% CI 0.15-0.78, P = 0.011) and EOS (HR 0.16, 95% CI 0.04-0.68, P = 0.013) decreased the mortality risk in AECOPD patients. Age, BMI, EOS and CRP were linearly correlated with one-year mortality of AECOPD. A post hoc analysis revealed that EOS (HR 0.17, 95% CI 0.04-0.70, P = 0.014) decreased the mortality risk in AECOPD patients at high altitude.
Conclusion: Patients with COPD at high altitude had a higher one-year mortality. Altitude and EOS are associated with one-year mortality in COPD patients, which underscores the potential therapeutic benefits of EOS in mitigating the mortality risk of AECOPD patients at high altitude.
期刊介绍：
BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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