Clinical Value Of IL-13 And Ecp In Serum And Sputum In Hospitalized Patients With Eosinophilic Aecopd

Objective:To observe the levels of interleukin-13?IL-13?and eosinophil cationic protein?ECP?in serum and sputum of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease?AECOPD?,and to explore their clinical value in hospitalized patients with eosinophilic AECOPD.Methods:A total of 108 hospitalized patients with AECOPD from October,2017 to August,2018 was collected in the Department of respiratory and critical medicine of our hospital.The patients included 85 males and 23 females with an average age of?70.56±9.31?years.According to the percentage of eosinophils?EOS?in peripheral blood,the patients were divided into eosinophilic group?EOS%?2%,group A?and non-eosinophilic group?EOS%<2%,group B?.The levels of IL-13 and ECP in serum and sputum were determined by enzyme-linked immunosorbent assay?ELISA?.To compare the clinical characteristics and laboratory indexes of the patients of two groups,and to explore the clinical value of serum,sputum IL-13 and ECP in hospitalized patients with eosinophilic AECOPD.Results:1.There were 52 cases in group A?48.15%?and 56 cases in group B?51.85%?.There were no significant differences in age,smoking index,body mass index,forced expiratory volume in one second as a percentage of predicted value?FEV₁%?,forced vital capacity as a percentage of predicted value?FVC%?and The ratio of forced expiratory volume in the first second to forced vital capacity?FEV₁/FVC%?between the two groups?P>0.05?.Compared with group B,men in group A were more common,with fewer acute exacerbations in the past year,shorter average hospitalization days,lower respiratory failure rate and mechanical ventilation utilization rate,and lower CAT and mMRC scores?P<0.05?.2.In group A,the absolute value and percentage of lymphocytes in peripheral blood and the percentage of lymphocytes in sputum were higher than those in group B?P<0.05?.While in group B,the absolute value and percentage of neutrophils in peripheral blood and the percentage of neutrophils in sputum of were higher than those of group A?P<0.05?,and the positive rate of sputum culture and biological indicators?NLR,CRP,PCT,FIB?were also higher than group A?P<0.05?.3.The levels of IL-13 and ECP in sputum in group A were higher than those in group B?P<0.05?,but there was no significant difference in serum between the two groups?P>0.05?.4.There was no significant correlation between peripheral blood EOS%and serum levels of IL-13 and ECP?P>0.05?,while peripheral blood EOS%was moderately positively correlated with sputum IL-13?r=0.531,P<0.001?,and peripheral blood EOS%was strongly positively correlated with sputum ECP?r=0.680,P<0.001?.5.The receiver operating characteristic?ROC?curves of sputum IL-13 and ECP predicting peripheral blood EOS%?2%of AECOPD inpatients were statistically significant?P<0.05?,the area under the curve?AUC?was 0.654 and 0.751.The Yoden index was the highest when the best cutoff value of sputum IL-13 was 42.45pg/ml and sputum ECP was 46.49pg/ml,the sensitivity was 66.7%and 69.7%,and the specificity was60.7%and 75.0%.Conclusion:1.Eosinophil in peripheral blood is a simple,convenient and inexpensive index for assessing the condition and prognosis of AECOPD patients.2.The expression of IL-13 and ECP in sputum of eosinophilic AECOPD was significantly better than that in peripheral blood.IL-13 and ECP in sputum could be used as biomarkers to evaluate the condition and prognosis of eosinophilic AECOPD inpatients.3.Both IL-13 and ECP are involved in the pathogenesis of eosinophilic AECOPD,which may be the basis of new targeted anti-inflammatory therapy in the future.