| Objective:Visiting induced acute neutrophils(IN),fractional exhaled nitric oxide(FeNO),and blood loss during acute exacerbation and clinical remission of chronic obstructive pulmonary disease(COPD)Changes in procalcitonin(PCT)and BODE index guide the use of antibiotics in patients with chronic obstructive pulmonary disease.Methods:From December 2014 to December 2015,100 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)hospitalized in the Department of Respiratory and Critical Care Medicine,Weifang Respiratory Hospital,aged 62-82 years,mean age(67.25 ± 9.34)years old,58 males and 42 females.All of them meet the diagnostic criteria of the 2014 Chinese version of AECPD for the diagnosis and treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD): patients with bronchodilator drugs,FEV1/FVC of lung function <70%,patients with confirmed chronic obstructive pulmonary disease have acute symptoms Cough,difficulty breathing,increased sputum volume(or)sputum purulent changes,and exceeds daily variation,and lead to the need to change daily medication.Exclusion criteria: 1 lung inflammation,pleural effusion,pneumothorax,congestive heart and arrhythmia and other diseases;2combined with bronchial asthma,lung abscess,pulmonary embolism,tuberculosis,interstitial pneumonia;3 can not tolerate lung function and 6 minutes walk tester.Twenty healthy volunteers in our hospital were selected as the control group,aged 22-42 years,mean age(28.5 ± 6.2)years old,10 males and 10 females.Patients were tested for induced neutrophil(IN)counts on the day after admission or before the second day of antibiotic use,and measured exhaled nitric oxide(FeNO),procalcitonin(PCT),lung function,body mass index,6 The 6 minute walk distance(6MWD)was used to evaluate the BODE index.At the same time,the sputum culture was carried out.The patients with cough and purulent sputum were(group A),and those with cough and sputum were(group B).Group A(36 cases),group B(64 cases).After the treatment,the patients were re-introduced with sputum neutrophil(IN)count,FeNO and PCT test,lung function,body mass index,6-minute walk test(6MWD),BODE index evaluation.In the healthy control group,only one induced neutrophil(IN)count,FeNO and PCT test,lung function,body mass index,6-minute walk test(6MWD),and BODE index were evaluated.Results:1.The pre-treatment sputum neutrophil counts in the two groups were compared with the healthy control group,group A > group B > control group,the difference was statistically significant(P < 0.05);two groups of patients before treatment FeNO and healthy control The group was compared,group A>B group>control group,the difference was statistically significant(P<0.05);the two groups of patients before treatment were compared with healthy control group,group A>B group>control group,the difference was statistically significant.Significance(P<0.05);the BODE scores of the two groups before treatment were compared with the healthy control group,group A>B group>control group,the difference was statistically significant(P<0.05).2.Before treatment,group A induced sputum central granulocyte count was positively correlated with PCT and BODE scores(r values were 0.434,0.458,respectively,P values were <0.0001,<0.0001),induced sputum neutrophil count and FeNO was not correlated(r value was-0.052,P value was 0.356),PCT was not associated with FeNO(r value was-0.072,P value was 0.412),and PCT was positively correlated with BODE score index(r value was 0.385,P The value was <0.0001),and FeNO was positively correlated with BODE score index(r value was 0.461,P value was <0.0001).Before treatment,group B induced sputum central granulocyte count was positively correlated with PCT and BODE score index,(r value They were 0.443 and 0.465,respectively,and the P values were<0.0001,0.0013,respectively.The induced neutrophil count was not correlated with FeNO(r value was-0.031,P value was 0.524),and PCT was not associated with FeNO.-0.036,P value was 0.421),PCT was positively correlated with BODE score index(r value was 0.235,P value was 0.0015),FeNO was not correlated with BODE score index(r value was 0.124,P value was 0.055).3.The neutrophil counts of the two groups were compared with the healthy control group.The neutrophil counts of the two groups were significantly decreased in the two groups.Group A>B>Control group,the difference was statistically significant(P<0.05);FeNO was compared with healthy control group after treatment.The FeNO values of the two groups were decreased in group 2,group B> control group,the difference was not statistically significant(P>0.05);The post-blood PCT was compared with the healthy control group.The PCT of the two groups decreased.The A group>the control group>B group had no significant difference(P>0.05).The BODE score index of the two groups after treatment was compared with the healthy control group.Comparing,BODE index of both groups decreased,group A>B group>control group,the difference was statistically significant(P<0.05).4.After treatment,the granulocyte count in group A was positively correlated with PCT(r value was 0.501,P value was <0.0001),and the induced neutrophil count was not correlated with FeNO and BODE scores.For-0.025,0.021,P values were 0.380,0.432,respectively,PCT was not associated with FeNO(r value was-0.061,P value was 0.483),and PCT was positively correlated with BODE score index(r value was 0.465,P value was < 0.0001),FeNO was not correlated with BODE score index(r value was-0.032,P value was 0.526).After treatment,group B induced sputum granulocyte count was positively correlated with PCT and BODE index scores(r value is 0.530,0.465,P values were <0.0001,0.0003,respectively.The induced neutrophil count was not correlated with FeNO(r value was 0.027,P value was 0.385,respectively),and PCT was not correlated with FeNO and BODE scores(r value).The values were-0.034 and 0.032,respectively,and the P values were 0.151 and 0.326,respectively.FeNO was not correlated with the BODE score index(r value was 0.031,P value was <0.001).5.Before and after treatment,the neutrophil counts of the sputum in the group A were compared twice,and the neutrophils induced by the sputum were significantly decreased after treatment(P<0.05).Before and after treatment,the patients in group B were twice.Compared with the induced neutrophil counts,the induced neutrophils of the sputum were also significantly decreased after treatment(P<0.05).Before and after treatment,the FeNO of the group A was compared twice,and the FeNO decreased significantly after treatment.The difference was statistically significant(P<0.05).Before and after treatment,the two groups of patients had a comparison of FeNO and FeNO decreased significantly after treatment(P<0.05).Before and after treatment,the serum PCT of group A was compared.The difference was statistically significant(P<0.05).Before and after treatment,the difference of serum PCT between the two groups was statistically significant(P<0.05).Before and after treatment,the two groups of patients had a comparison of BODE scores after treatment.The BODE score index decreased,and the difference was statistically significant(P<0.05).Before and after treatment,the BODE scores of the B group were compared,and the BODE score decreased after treatment(P<0.05).6.Before treatment,all 100 patients were positively correlated with PCT and BODE scores(r values were 0.513,0.486,P values were <0.0001,0.0026,respectively),and induced neutrophil counts.It was not associated with FeNO(r value was 0.013,P value was 0.635),PCT was not associated with FeNO(r value was-0.053,P value was 0.487),and PCT was positively correlated with BODE score index(r value was 0.358,P The values were <0.0001),and FeNO was positively correlated with the BODE score index(r value was 0.473,P value was <0.0001).7.After treatment,all 100 patients were positively correlated with PCT and BODE scores(r = 0.426,0.536,P = <0.0001,<0.0001,respectively),induced sputum neutrophils The count was not correlated with FeNO(r value was-0.017,P value was 0.369),and PCT was not correlated with FeNO and BODE score indices(r values were-0.028,-0.102,respectively,P values were 0.441,0.635,respectively),FeNO and The BODE score index was irrelevant(r values were 0.189 and P values were 0.076).8.In the healthy control group,the granulocyte counts in 20 volunteers were not correlated with the PCT and BODE scores(r values were 0.016,-0.036,respectively,P values were 0.453,0.768),and sputum neutrophils were induced.The count was not correlated with FeNO(r value was-0.024,P value was 0.643),PCT was not correlated with FeNO and BODE scores,(r values were-0.15,0.014,P values were 0.683,0.792,respectively),FeNO and BODE.The score index was irrelevant(r value was-0.203,P value was 0.867).Conclusions:1.In the acute exacerbation of patients with chronic obstructive pulmonary disease,the neutrophil(IN)count,FeNO,PCT,and BODE index scores were significantly increased in the sputum,and the above indicators were significantly decreased during the remission period.2.Induction of sputum neutrophils was not associated with FeNO levels.3.The severity of infection in patients with chronic obstructive pulmonary disease was well correlated with the induction of neutrophil(IN)count,FeNO and PCT,BODE index scores,and the detection of induced neutrophil(IN)count,FeNO and PCT.The BODE index assessment is used to judge the severity of acute exacerbation and infection in patients with chronic obstructive pulmonary disease,improve the accuracy of judgment,guide the selection of antibiotics,and serve clinical work. |
PDF Full Text Request