The Expression And Meaning Of Total Serum IgE In The Patients With The Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: In AECOPD(Acute Exacerbation of Chronic Obstructive Pulmonary Disease) glucocorticoid therapy, patients were observed before and after glucocorticoid treatment of different T-IgE in forced expiratory volume in one second(FEV1), FEV1 / FVC ratio, forced expiratory volume in one second percent predicted(FEV1% pred) and improved the UK MRC dyspnea index(m MRC), investigate different T-IgE levels in patients with AECOPD significance of glucocorticoid therapy.Object: There are 90 hospitalized AECOPD cases Selected in the Yan’an University Affiliated Hospital from March, 2013 to December, 2014, all cases are up to standard the Chinese Medical Association "chronic obstructive pulmonary disease diagnosis and treatment guidelines" Acute Exacerbation Chronic Obstructive Pulmonary Disease diagnostic criteria. In the 90 cases, 50 of which were males and 40 of which were females, and their age range is from 50 to 82 years old, the average age is 65.40 ± 10.52 years old. Exclusion criteria:(1) The patients who have received glucocorticoids treatment in the past one month;(2) The patients who can not bear pulmonary function tests;(3) The patients who have a history of allergies, rhinitis and(or) eczema;(4) The patients who suffer from liver, kidney and endocrine diseases meanwhile;(5) The patients whose dung was tested to be parasite infections.Methods: Determination of patients’ IgE level, if the results are more than 100 IU / ml, they belong to T-IgE-positive; in turn, if the results are less than 100 IU / ml, they belong to T-IgE negative, according to the T-IgE levels of 90 patients they were divided into T-IgE-positive group and T-IgE-negative group. Both groups were given glucocorticoid treatment, low flow oxygen therapy, anti-infective therapy, support symptomatic treatment. The patients were examined forced expiratory volume in one second(FEV1), FEV1 / FVC ratio, forced expiratory volume in one second percent predicted(FEV1%pred) and improved the UK MRC dyspnea index(m MRC) before treatment. After 7-day treatment, the patients were also examined forced expiratory volume in one second(FEV1), FEV1 / FVC ratio, forced expiratory volume in one second percent predicted(FEV1%pred) and improved the UK MRC dyspnea index(m MRC). Using statistical methods to deal with the results of the above statistics, in order to study the meaning of the total serum IgE in the patients with the acute exacerbation of chronic obstructive pulmonary disease.Results: The patients in each group forced expiratory volume in one second(FEV1), FEV1 / FVC ratio, forced expiratory volume in one second percent predicted(FEV1%pred) and improved the UK MRC dyspnea index(m MRC) were: the results of T- IgE-positive group before treatment:(1.46 ± 0.12) L,(54.73 ± 6.63)%,(55.18 ± 3.90)%,(3.50 ± 0.52); the results of T-IgE-positive group after 7-day treatment:(1.85 ± 0.17) L,( 67.61 ± 6.86)%,(67.69 ± 6.80)%,(1.90 ± 0.47); the results of T-IgE-negative group before treatment:(1.48 ± 0.11) L,(55.45 ± 6.42)%,(56.40 ± 3.88)%,(3.60 ± 0.51); the results of T-IgE-negative group after 7-day treatment:(1.57 ± 0.16) L,(62.32 ± 6.42)%,(63.49 ± 5.96)%,(3.10 ± 0.56).1. In the 90 cases, compared T-IgE-negative group with the T-IgE-positive group, there is no statistical significance in age and sex(P> 0.05).2. T-IgE-negative group and T-IgE-positive patients before treatment, there is no statistical significance in forced expiratory volume in one second(FEV1), FEV1 / FVC ratio, forced expiratory volume in one second percent predicted(FEV1%pred) and improved the UK MRC dyspnea index(m MRC)(P> 0.05).3. There exsits statistical significance between T-IgE-positive group after 7-day treatment and before treatment,(P <0.01). P value of FEV1, FEV1 / FVC, FEV1%pred, m MRC were 0.000(t=14.396), 0.000(t=-10.370), 0.000(t=-12.258), 0.000(t=-17.533).4. There exists statistical significance between T-IgE- negative group after 7-day treatment and before treatment,(P <0.05). P value of FEV1, FEV1 / FVC, FEV1%pred, m MRC were 0.012(t=-2.581), 0.000(t=-4.212), 0.000(t=-5.551), 0.001(t=3.675).5. There exsits significant statistical significance both T-IgE-positive group and T-IgE-negative group after 7-day treatment,(P <0.01), which explained that after 7-day treatment the T-IgE-positive group improved significantly in the treatment of various indicators. P value of FEV1, FEV1/FVC, FEV1%pred, m MRC were 0.000(t=8.031), 0.000(t=3.627), 0.003(t=3.025), 0.000(t=-11.300).Conclusion:1. Detection of T-IgE method is simple, which can obtain quantitative results in a relatively short time. In this study, 34.44% of AECOPD patients show positive expression, which indicated that some patients with AECOPD had T-IgE positive expression.2. Compared T-IgE-positive group with the T-IgE-negative group, AECOPD patients by glucocorticoid therapy, the patient lung function(FEV1, FEV1 / FVC, FEV1%pred) and m MRC are significantly improved, which indicated AECOPD patients with T-IgE expression are sensitive to glucocorticoid therapy, thus the effects of glucocorticoids are better.3. In acute exacerbation chronic obstructive pulmonary disease phenotype, some patients are elevated T-IgE levels, suggesting that the phenotype can be classified based on total serum IgE, after phenotypic classification, based on T-IgE level of the patient glucocorticoid individual treatment.4. In AECOPD glucocorticoid therapy, T-IgE-positive patients behave sensitive to glucocorticoid, T-IgE detection of hormone therapy in patients with AECOPD have some guidance, T-IgE detection to guide the clinical application of hormonal control slow resistance lungs.