The Value Of Peripheral Blood Eosinophils In Predicting The Efficacy And Evaluating The Prognosis Of AECOPD

Objective To explore the value of the level of eosinophil in peripheral blood in the prediction of curative effect and prognosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods According to the inclusion and exclusion criteria,the medical records of AECOPD patients admitted to the department of respiratory medicine in our hospital from January 2016 to April 2018 were collected,according to blood cell analysis on admission,patients were divided into two groups:EOS%?2%group and EOS%<2%group.(1)General clinical data of the two groups were compared,such as age,gender,smoking history,history of basic diseases(complications),and blood cell analysis,blood gas analysis and lung function within 24 hours of admission.(2)After conventional comprehensive treatment,the treatment regimen was basically the same,the days of glucocorticoid use during hospitalization,length of stay,improvement of oxygenation index,lung function related indicators(FEVlpre,FVC),CAT score after 5 days of treatment and whether the use of mechanical ventilation were compared between the two groups.(3)The above discharge cases were followed up to observe whether the frequency of moderate and severe acute exacerbations,the ratio of readmission and the fatality rate were correlated with the blood eosinophil level within 6 months after discharge.Results From January 2016 to April 2018,a total of 135 patients with AECOPD were enrolled in the department of respiratory medicine of our hospital,including 35 patients in the EOS%?2%group and 100 patients in the EOS%<2%group.(1)the age,gender,smoking history,history of basic diseases(comorbidity),blood gas analysis(PH,PCO2,PO2,SaO2%),lung function indexes FEVlpre and FVC within 24 hours after admission showed no significant difference between the two groups(all P>0.05).Blood cell analysis(total number of leukocytes and percentage of neutrophils)between the two groups within 24 hours after admission showed statistically significant differences(all P<0.05).(2)After conventional comprehensive treatment,the days of glucocorticoid use and duration of hospitalization in patients with EOS%?2%were significantly lower than those in patients with EOS%<2%(P<0.05);the improvement of oxygenation index,lung function related indicators(FEVlpre,FVC)and CAT score after 5 days of treatment was better than that of EOS%<2%group(P<0.05);the use rate of mechanical ventilation during hospitalization was lower than that of EOS%<2%group(P<0.05).(3)The Times of moderate and severe acute exacerbations and the case fatality rate were correlated with the blood eosinophil level within 6 months after discharge(P<0.05),but the proportion of readmission within 6 months after discharge was not significantly correlated with the blood eosinophil level.The mortality of patients with acute exacerbation of copd within 6 months after discharge in the EOS%?2%group was less than that in the EOS%<2%group.The Times of moderate and severe acute exacerbations in the EOS%?2%group were more than those in the EOS%<2%group within 6 months after discharge,and the differences were statistically significant(all P<0.05).The readmission rate in the EOS%?2%group was less than that in the EOS%<2%group within 6 months after discharge,but the difference was not statistically significant(P>0.05).Conclusions Blood eosinophils play a guiding role in stratified treatment of patients with acute exacerbation of chronic obstructive pulmonary disease.The group with elevated blood eosinophils is more sensitive to hormone therapy and may help determine the prognosis of this disease.