Clinical Research Of Blood Eosinophils For The Prevention Of Acute Exacerbation Of Patients With Stable Chronic Obstructive Pulmonary Disease By Inhaled Corticosteroids

Objective: This study examines the percentage of blood eosinophils for the treatment of patients with stable chronic obstructive pulmonary disease using inhaled corticosteroidsto prevent acute exacerbations?the risk of developing pneumonia and the effect on lung function.Methods: A total of 159 patients with chronic obstructive pulmonary disease were enrolled in the Department of Respiratory Diseases,the Second Affiliated Hospital of Suzhou University,2015-2016.These patients had one or more exacerbation the previous year.We recorded their sex,age and score of C AT.Blood eosinophil percentage and lung function was messured and recoreded.The patients were divided into two groups: treatment group(with ICS/LABA)and control group(without drugs).Then we divided these patient into 5 groups based on there blood eosinophil percentage.result:1.Of the 159 patients,115 patients received ICS / LABA treatment,the average number of acute exacerbations was 0.73 ± 0.55,and 44 patients did not receive drug therapy.the average number of acute exacerbations in the treatment group was 1.16 ± 0.43,compared with the control group the average number of acute exacerbations was significantly reduced,the difference was statistically significant(p = 0.000).2.The patients with blood eosinophil less than 1.0%,the treatment group was 47 cases,the average annual acute exacerbation was 0.85 ± 0.59,the control group was 21 cases,the average annual acute exacerbation was 1.10±0.44,there was no statistical difference between treatment group and controlled group.(p = 0.094);the patients with blood eosinophil 1.0% or more,the treatment group was 68 cases,the number of acute exacerbations in the treatment group was 0.65±0.54,the control group was 23 cases,the number of acute exacerbations was 1.22±0.42.The number of acute exacerbations in the treatment group was significantly lower than that in the control group.(p= 0.000).3.Patients with blood eosinophils less than 2.0%,the treatment group was 61 cases,the number of acute exacerbations was 0.82 ± 0.60,the control group was 34 cases,the number of acute exacerbations was 1.12±0.41,patients with eosinophils or 2.0% or more,the treatment group was 54 cases,the number of acute exacerbations was 0.63 ± 0.49,the control group was 10 cases,the number of acute exacerbations was 1.30±0.48.The number of acute exacerbations in the treatment group was significantly lower than that in the control group(p = 0.000).4.Patients with blood eosinophils less than 3.0%,the treatment group was 79 cases,the number of acute exacerbations was 0.78 ± 0.57,the control group was 38 cases,the number of acute exacerbations was 1.13± 0.41.The number of acute exacerbations in the treatment group was significantly lower than that in the control group.(p= 0.001).5.Patients with blood eosinophils less than 4.0%,the treatment group was 92 cases,the number of acute exacerbations was 0.75 ± 0.59,the control group was 41 cases,the number of acute exacerbations was 1.15± 0.42.The number of acute exacerbations in the treatment group was significantly lower than that in the control group.(p = 0.000).,patients with blood eosinophils 4.0% or more,the treatment group was 23 cases,the numb er of acute exacerbations was 0.57 ± 0.51,the control group was 3 cases,the number of acute exacerbations was 1.33± 0.58.The number of acute exacerbations in the treatment group was significantly lower than that in the control group.(p = 0.023).,6.In all patients,the incidence of pneumonia in the control group was 3/44(6.8%);The incidence of pneumonia in the treatment group was 8/115(7.9%),the incidence of pneumonia in both groups was no significant difference(p = 1.000).7.The change of post-FEV1% in the treatment group was(-1.57 ± 1.76)and in the control group was(-3.14 ± 1.61).The chage of Post-FEV1% was significantly lower in the treatment group than that in the control group.(p = 0.000).8.The patients with blood eosinophils 2.0% to 3.0%,3.0% to 4.0% and 4.0%or more,The chage of Post-FEV1% was significantly lower in the treatment group than that in the control group.conclusion:Peripheral blood eosinophil percentage ? 1.0% of patients with chronic obstructive pulmonary disease,the treatment group can significantly reduce the number of annual mean acute exacerbations than the control group.There was no statistically significant difference in the incidence of pneumonia between patients with different eosinophils and ICS / LABA treatment.The reduction of Post-FEV1% in the treatment group was s lower than that in the control group.