Clinical Study Of Chronic Obstructive Pulmonary Disease With Acute Exacerbation Of Phegm And Airway Inflammation

Objective: To investigate the relationship between phlegm syndromes and airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods: 90 cases with acute exacerbation of chronic obstructive pulmonary disease were differentiated into 3 groups equally according to heat-phlegm syndrome(S1), cold-phlegm syndrome(S2) and non-phlegm syndrome(S3). Blood routine, T lymphocyte, serum tumor necrosis factor-a , serum interleukin-8, serum C-reactive protein, sputum culture, chest radiography and lung function were detected in each case. The differences of above indexes among 3 groups and the correlations between results and SI or S2 were observed.Results:The levels of neutrophil%(N%), TNF- a , IL-8, airway resistance(R5) in heat-phlegm syndrome group were higher than those in cold-phlegm syndrome Significantly. While the levels of lymphocyte%(L%), CD3+T-lymphocyte, CD8+T-Lymphocyte, forced expiratory volume in one second(FEV1), forced vital capacity (FVC) , maximal midexpiratory flow curve(MMEF) were decreased. And there were no differences on levels of CRP, degree of airway inflammation on chest radiography. Compared with those of S3, the levels of N%, CD3+T, CD8+T, TNF- , IL-8, CRP, degree of airway inflammation on chest radiography were significantly increased in S1, but the levels of CD3+T, CD8+T, TNF- , IL-8, CRP, degree of airway inflammation on chest radiography were decreased. There were no differences on L%, FEV1. FVC, MMEF, R5 between S1 and S3, no differences on N%, L%, FEV1, FVC, MMEF, R5 between S2 and S3,no differences on leukocyte, CD4+T, RV/TLC, FEV1/FVC, positive rate of sputum culture among 3 groups. Positive correlations were demonstrated between clinical manifestations and levels of TNF- , IL-8, CRP in S1, and levels of TNF- , degree of airway inflammation on chest radiography in S2, On the contrary, negative correlations were found between the level of L% and SI manifestation, and between the levels of N%,leukocyte and S2.Conclusions:In patients with acute exacerbation of obstructive pulmonary disease, there is a close correlation between phlegm syndromes and airway inflammation. There have differences on airway inflammation among heat-phlegm syndrome, cold-phlegm syndrome and non-phlegm syndrome. Neutrophils play an important role on airway inflammation in heat-phlegm syndrome. T-lymphocytes do in cold-phlegm syndrome as well. Study results provide some objective indicators for differentiation of phlegm syndromes in acute exacerbation of chronic obstructive pulmonary disease.