Practical Value Of Peripheral Blood Eosinophils In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:Chronic obstructive pulmonary disease?COPD?is a common and frequently-occurring disease of the respiratory system.Chronic airway inflammation is the core mechanism of progression of COPD disease.A variety of inflammatory cells?neutrophils,macrophages,lymphocytes,etc.?are involved in airway inflammation,and in some cases,eosinophils?EOS?are also involved in airway inflammation.Chronic inflammatory reactions can cause destruction of the lung parenchyma and small airway fibrosis,which in turn leads to progressively increased airflow limitation.Clinically,treatment is usually guided by the degree of airflow limitation.However,atypia exists in the treatment response of COPD.What's more,with the accumulation of anti-inflammatory-oriented research in the treatment,the role of EOS in the pathophysiological process of COPD is continuously recognized and can be used to guide the application of glucocorticoids?GCS?and judgment of acute exacerbation risk.Foreign studies suggest that,taken as a biomarker,blood EOS,measured at the beginning of the acute exacerbation of chronic obstructive pulmonary disease?AECOPD?,can guide the use of glucocorticoids.This thesis studied the clinical characteristics of AECOPD hospitalized patients with different peripheral blood EOS levels?EOS%?,and explored the guiding value of peripheral blood EOS in AECOPD patients'disease assessment,treatment and prognosis.Methods:According to the inclusion and exclusion criteria,the patients were retrospectively analyzed,which includes 376 AECOPD patients hospitalized from January 1 to December 2017 in the department of respiration I and II of the First Affiliated Hospital of Dalian Medical University.All selected patients were discharged from hospital.There are 265 male patientsand 111 female patients,aged between 42-94.EOS%was divided into two groups according to blood routine at admission,EOS%?2%for eosinophil group?group I?,EOS%<2%for non-eosinophil group?group II?.There are 197 cases in group I and 179 cases in Group II.The two groups were compared form the following perspectives:the age,sex,smoking history,length of COPD,hypertension,diabetes,C-reactive protein?CRP?,procalcitonin?PCT?,erythrocyte sedimentation rate?ESR?,serum total IgE,and arterial blood gas analysis?PaO₂,PaCO₂?,pulmonary function?FEV1%pred?,the use of mechanical ventilation,the number of hospital stays.In addition,the number of hospital stays in patients treated with systemic glucocorticoid therapy is also compared in this research.Result:1.A total of 376 patients with AECOPD had been researched,among which there were 197 patients with group I accounting for 52.39%,and 179 patients with group II,accounting for 47.61%.2.There were significant differences in gender,smoking history,age,and COPD course between the two groups.3.There was no significant difference in the incidence of hypertension and diabetes complications between the two groups.4.Compared with group I,the levels of CRP and PCT in group II were significantly increased?P<0.05?,the mechanical ventilation rate in group II was significantly increased?P<0.05?and the hospital stay was significantly prolonged?P<0.05?.The research also found that Compared with group I,the blood oxygen partial pressure of group II patients was significantly decreased?P<0.05?and the blood carbon dioxide partial pressure was significantly increased?P<0.05?.There was no significant difference in erythrocyte sedimentation rate,serum total IgE and FEV1%pred between the two groups.5.There was a statistically significance in hospitalization time between the two groups of patients who received systemic glucocorticoid therapy.The hospitalization time of group I patients was significantly decreased?P<0.05?.In conclusion:1.The proportion of EOS in peripheral blood contributes to the evaluation of causes of acute exacerbation of COPD patients.2.The proportion of EOS in peripheral blood contributes to the assessment of severity of acute exacerbation of COPD patients.3.The proportion of EOS in peripheral blood contributes to the prediction of hospital stay of systemic glucocorticoid therapy AECOPD.