Blood Eosinophilia In Chronic Obstructive Pulmonary Disease Exacerbations：Prevalence And Clinical Characteristics

Objectives:Compare the clinical characteristics of COPD subjects with eosinophilic and non-eosinophilic exacerbations.Explore the differences between two groups in exacerbation rates during 6 months.Methods: 122 COPD patients with acute exacerbations who visited the First Affiliated Hospital of Soochow University from July 2015 to July 2016 were recruited into this study.According to the peripheral blood eosinophil on admission,patients were divided into two groups.Eosinophilic group(a)is peripheral blood eosinophil≥2% of total leukocyte count and the others is in non-eosinophilic group(b).Clinical data was collected at admission.According to the guidelines,every patient was treated.The CAT scores were collected at 1st week,2nd week and 6th week after treatment and the exacerbation rate was followed up for about 6 months.Admission details,CAT scores and the exacerbation rates were compared between two groups.Results:1.A total of 122 COPD patients with acute exacerbations were recruited.After about 7 months’ follow-up,a total of 88 subjects have completed this study.40.9% of subjects met our criteria for peripheral blood eosinophil≥2% of total leukocyte count.2.There was a statistically significant correlation between FeNO levels and the peripheral blood eosinophil count/ percentage in COPD patients with acute exacerbations(p<0.05)and the correlation coefficients were 0.2781 and 0.3257.3.There was no significant difference in CAT scores between the two groups after treatment(p>0.05).But time point,the interactions between grouping and time point were significant(p<0.05).Compared with the point at exacerbation,each point of two groups were significant.There was no significant difference in the CAT scores between 2nd or 6th week and stable COPD in group(a)(p>0.0071).Except for 6th week,the CAT scores of group(b)at the other time points were significantly different comparing with the time point of stable COPD(p<0.0071).4.The patients were followed up for 6 months after 6 weeks of recovery from COPD exacerbations.The exacerbation rates were not significant difference between two groups during 6 months(p>0.05).Conclusions:1.There was a weak positive correlation between peripheral blood eosinophil count/ percentage and FeNO level in COPD patients with acute exacerbations.It is not considered both substitutes.2.The CAT scores of COPD patients with eosinophilic exacerbation decreased rapidly after treatment.The results suggested that peripheral blood eosinophil count can predict the short-term curative effect of COPD patients with acute exacerbations.3.It is not clear that higher peripheral blood eosinophils at admission in the patients with COPD exacerbation can predict the risk of acute exacerbation in the next six months.