The Predictive Value Of Peripheral Blood Eosinophil(Eos)on Acute Exacerbation In Clinical Efficacy Of Chronic Obstructive Pulmonary Disease

Objective:to analyze the relationship between the percentage of peripheral blood eosinophil(B-Eos)and its clinical efficacy in patients with Acute Exacerbation Chronic Obstructive Pulmonary Disease(AECOPD).Methods:Selected patients with Chronic Obstructive Pulmonary Disease(COPD)in the first affiliated hospital of Suzhou university from May 2016 to December 2017,recording all COPD patients' age,gender,history of COPD and basic information such as smoking history,clinical symptoms,lung function based application status,medical history,history of drugs,the percentage of the predicted value of FEV1 measured at stable period(FEV1%pred),to set up files.When patients come to our hospital again because of the acute exacerbation of chronic obstructive pulmonary diseases(AECOPD),they will be as study cases,with a total number of 110,according to hospital percentage of eosinophils(Eos)in peripheral blood of patients,they were divided into two groups:low proportion of eosinophils group(group ?,B-Eos%<2%)and high proportion of acidophilic granulocyte group(group ?,B-Eos%?2%).The laboratory tests of all COPD patients with acute attack were recorded again:acidophilic fine percentage,white blood cell count,center granulocyte count,fractional exhaled nitric oxide(Fe NO),COPD assessment test(CAT),length of hospital stay,etc.According to the 2013 GOLD guidelines,patients with AECOPD were treated accordingly,and glucocorticoid(40mg intravenous drip or 4ml spray inhalation of budesonide)was administered,CAT questionnaire was assessed again on the 7th day after treatment(patients who were discharged on the 7th day were assessed by telephone).The obtained data were statistically analyzed by SPSS22.0 software.The measurement data were expressed as mean plus or minus standard deviation(x plus or minus s),and the comparison of the mean between the two groups was performed with the t-test of two independent samples.Counting data was expressed by frequency and percentage,and compared between groups by x2 test.Correlations between the indicators were analyzed using Pearson correlation.P<0.05 was considered statistically significant.Results:1.110 AECOPD elderly patients were included,including 84 male patients(76.4%)and 26 female patients(23.6%),aged between 60 and 84 years old,of which 41.8%with B-Eos%? 2%.2.As for peripheral blood Eos percentage groups,the group ?(B-Eos%<2%)with 64 cases of patients,while group ?(B-Eos%?2%)in patients with 46 cases,the index comparison results between the two groups are as follows:(1)comparing clinical data of two groups as age,sex,smoking history,hypertension,using hormones between,no statistical significance(all P>0.05),diabetes,stability of FEV1%Mr Pred was statistically significant(all P<0.05).(2)comparing WBC count,Neu count and FeNO value between the two groups at 24 hours after admission,there was statistical significance(all P<0.05).(3)Comparing the length of hospital stay between the two groups,there was statistical significance(P<0.05).(4)CAT scores at admission were compared between the two groups.There was no statistical significance(P>0.05),and CAT scores were compared again 7 days after treatment.There was statistical significance(P<0.05).CAT scores at admission and 7 days after treatment were compared in group ? and group II.There was statistical significance(all P<0.05).3.Pearson correlation analysis showed that WBC and Neu were negatively correlated with B-Eos%,while FeNO was positively correlated with B-Eos%.Conclusions:1.The FeNO value was higher on admission in AECOPD patients with the percentage of eosinophil in peripheral blood>2%,suggesting that-glucocorticoid can effectively alleviate airway inflammation in AECOPD patients with increased eosinophil in peripheral blood and shorten the length of hospital stay.2.For AECOPD patients with the percentage of eosinophil in peripheral blood greater than 2%,CAT questionnaire score decreased rapidly on the 7th day after treatment,and the actual number of hospitalized days decreased,suggesting that the level of eosinophil in peripheral blood may predict the therapeutic effect of AECOPD.3.The percentage of the peripheral blood eosinophils of AECOPD patients was positively correlated with FeNO value,indicating that the proportion of the peripheral blood eosinophils was correlated with airway inflammation.