Changes And Clinical Analysis Of Inducing Sputum Neutrophils In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:Due to the heterogeneity of chronic obstructive pulmonary disease(COPD),the acute exacerbation of COPD(AECOPD)inflammatory response is not consistent in different individuals.Induced sputum is a non-invasive and effective assessment of airway inflammation.This paper aims to summarize the classification and classification of AECOPD-induced sputum cells,analyze the correlation between induced sputum neutrophils and peripheral blood neutrophils and annual smoking,compare the differences in induced neutrophil neutrophil at different levels of C-reactive protein,procalcitonin,sputum culture,and chest CT.Methods:The study was conducted using a retrospective approach.The subjects of the study were AECOPD inpatients in the Department of Respiratory Medicine from June 2016 to June 2017.The patients were enrolled in the classification of induced sputum cells,blood cell classification,blood C-reactive protein,procalcitonin,sputum culture,and thoracic CT data.The characteristics of AECOPD-induced nevus cell sorting were analyzed and the correlation between neutrophil induced neutrophil and peripheral blood neutrophils and the annual smoking volume was studied.To compare the difference of neutrophils induced by peripheral blood neutrophils,C-reactive protein,procalcitonin,sputum culture,and thoracic CT..Results:1.In this study,the AECOPD induced sputum phenotype was 45 cases(68%)of neutrophils,1 case of eosinophils(2%),and 20 cases of mixed cells(30%).Induced sputum neutrophils and peripheral blood neutrophils were positively correlated(r=0.347,P=0.004),and higher in the peripheral blood neutrophils group than in the normal group,the difference was statistically significant(t=2.56,P=0.013).2.The neutrophil-induced increased significantly in the C-reactive protein increase group and the normal group.There was no significant difference between the two groups(t=1.84,P=0.074).Subgroup analysis: neutrophil-type AECOPD,induced sputum neutrophils in the C-reactive protein increased group and the normal group was significantly different(t = 2.44,P = 0.025),higher in the increased group than the normal group;mixed In cell-type AECOPD,the difference between the two groups was not statistically significant(t =-1.228,P = 0.24),and was lower in the increased group than in the normal group.3.The neutrophil-induced in the PCT elevated group and the normal group were significantly increased.The difference between the two groups was statistically significant(t=2.379,P=0.021).It was higher in the elevated group than in the normal group.Subgroup analysis: neutrophil-type AECOPD,induced sputum neutrophils in the PCT elevated group compared with the normal group was significantly different(t =2.103,P = 0.042),higher in the elevated group than the normal group;mixed There was no increase in PCT in the cell type.4.The neutrophil-induced were significantly increased between the sputum culture positive group and the normal group.The difference between the two groups was statistically significant(t=3.158,P=0.003),and it was higher in the positive group than in the normal group.Subgroup analysis: neutrophil-type AECOPD,induced sputum neutrophils in the sputum culture positive group compared with the normal group was significantly different(t = 3.05,P = 0.004);mixed cell type in the two groups The difference was not statistically significant(t=-0.732,P=0.475)and was lower in the positive group than in the normal group.5.The neutrophil-induced were significantly increased in the chest CT positivegroup and the control group.There was no significant difference between the two groups(t=0.762,P=0.45).Subgroup analysis: neutrophil-type AECOPD,induced sputum neutrophils in the chest CT positive group compared with the control group there was a significant difference(t = 3.564,P = 0.001);mixed cell type in the two groups The difference was not statistically significant(t=-1.704,P=0.111)and was lower in the positive group than in the control group.6.Induced sputum neutrophils in AECOPD negatively correlated with the annual smoking volume(r=0.256,P=0.048).conclusion:1.Neutrophil type and mixed cell type are common phenotypes of AECOPD-induced sputum cytology.2.Induced sputum neutrophils may be more sensitive than blood neutrophils,C-reactive protein,and procalcitonin in reflecting acute inflammation in AECOPD lungs.3.Long-term heavy smoking can harm the body's immune system,resulting in the relatively low expression of neutrophils in the lungs of AECOPD.Its clinical significance is worth exploring in depth.