Objective: To investigate the risk factors and prognosis of cardiovascular damage in hypereosinophilia (HE).
Methods: The clinical data of 62 patients with HE in Gansu Provincial Hospital from January 2015 to December 2020 were retrospectively analyzed, including clinical characteristics and laboratory indicators, and the influencing factors of survival and prognosis were also analyzed.
Results: In this study, there were 34 males and 28 females, with a median age of 53.5 (20-79) years, 35 patients without cardiovascular damage, 27 patients with cardiovascular damage, including 22 patients with abnormal electrocardiogram (ECG) (81.5%), 18 patients with abnormal echocardiography (ECHO) (66.7%), 9 patients with single ECG abnormality, 5 patients with single ECHO abnormality, and other 13 patients with multiple abnormalities. In cardiovascular damage group, peripheral white blood cell count, absolute value of eosinophils, troponin T (TNT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), interleukin (IL)-4 and IL-5 levels at initial diagnosis were significantly higher than those in the non-cardiovascular damage group (P <0.01), while hemoglobin, IL-2 and interferon-γ levels were significantly lower (P <0.01). There were no significant differences in age, sex, course of disease, etiological classification, platelet count, serum creatine kinase, serum creatine kinase isoenzyme and lactate dehydrogenase between the two groups (P >0.05). The 5-year overal survival rate of patients with cardiovascular damage was 88.9%, and that of patients without cardiovascular damage was 100%, the difference was statistically significant (P =0.012). The 5-year event-free survival (EFS) rate of patients with cardiovascular damage was 59.3%, and the median time was 37 (21-52) months, while that of patients without cardiovascular damage was 80%, and the median time was 63 (51-74) months (P =0.002). Age (>60 years old), course of disease (>24 months), NT-proBNP (>3 000 pg/ml), TNT (>100 ng/L), elevated IL-4 and IL-5 were associated with EFS shortening in patients with cardiovascular damage, which were independent risk factors for EFS.
Conclusion: The EFS rate in HE patients without cardiovascular damage is significantly higher than patients with cardiovascular damage. Age, course of disease, NT-proBNP, TNT, IL-4 and IL-5 are independent risk factors affecting EFS of patients with cardiovascular damage.
题目: 高嗜酸性粒细胞增多症心血管损害相关危险因素及预后分析.
目的: 探讨高嗜酸性粒细胞增多症（HE）心血管损害相关危险因素及预后。.
方法: 回顾性分析2015年1月- 2020年12月在甘肃省人民医院确诊为HE的62例患者的临床资料，对患者的临床特征及实验室指标进行分析，并分析其生存和预后的影响因素。.
结果: 62例HE患者中男性34例，女性28例，中位年龄53.5（20-79）岁，35例为非心血管损害患者，其余27例合并心血管损害，其中心电图异常22例（81.5%），超声心动图异常18例（66.7%），9例患者为单一心电图异常，5例患者为单一超声心电图异常，13例患者合并多种异常情况。心血管损害患者初诊时外周血白细胞数、嗜酸性粒细胞绝对值、肌钙蛋白T、N端B型利钠肽前体、白细胞介素4和白细胞介素5水平均明显高于非心血管损害患者（P <0.01），而血红蛋白、白细胞介素2、γ干扰素水平均明显低于非心血管损害患者（P <0.01），两组患者年龄、性别、病程及病因学分类、血小板数、血清肌酸激酶、血清肌酸激酶同工酶、乳酸脱氢酶水平比较则无统计学差异（P >0.05）。心血管损害患者5年存活率为88.9%，非心血管损害患者为100%（P =0.012）；心血管损害患者5年无事件生存（EFS）率为59.3%，中位时间为37(21-52)个月，非心血管损害患者5年EFS率为80%，中位时间为63（51-74）个月（P =0.002）。年龄（>60岁）、发病病程（>24个月）、N端B型利钠肽前体（>3 000 pg/ml）、肌钙蛋白T（>100 ng/L）、白细胞介素4、白细胞介素5水平升高与心血管损害患者EFS缩短相关，是EFS的独立危险因素。.
结论: HE非心血管损害患者的EFS率明显高于心血管损害患者，年龄、病程、N端B型利钠肽前体、肌钙蛋白T、白细胞介素4、白细胞介素5水平是影响心血管损害患者EFS的独立危险因素。.
Keywords: event-free survival; cardiovascular damage; hypereosinophilia; overall survival; prognosis.