Predictive Value Of Blood Eosinophils In The Treatment Of Hormone In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective Patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)are grouped according to the measured percentage of eosinophils in the blood.AECOPD patients in different groups have different responses to glucocorticoid treatment.To investigate the predictive value of blood eosinophils in the treatment of hormone in patients with AECOPD.Methods 160 patients with acute exacerbation of chronic obstructive pulmonary disease who were admitted to the Department of Respiratory Medicine,the Third Affiliated Hospital of Anhui Medical University from August 1,2017 to April 30,2018 were selected.All patients were tested for percentage of blood eosinophils(EOS%),exhaled nitric oxide(Fe NO),percutaneous oxygen saturation(SPO2),C-reactive protein(CRP),count the number of acute exacerbations in the previous year,and fill in COPD Assessment Test(CAT)questionnaire.According to the EOS%,the patients were divided A and B groups,each group was randomly divided into two groups(with or without inhaled hormone treatment),that is,group A1(EOS% ? 2%,Inhaled glucocorticoid,A2 group(EOS% ? 2%,No inhaled glucocorticoid),B1 group(EOS% < 2%,Inhaled glucocorticoid)and B2 group(EOS% < 2%,No inhaled glucocorticoid).On the 7th day of treatment,the lung function of the patient was measured and EOS%,SPO2,and CAT were retested.Then the difference among the four groups in treatment effect was analyzed.During the 1-year follow-up,the patients was instructed to inhale budesonide formoterol powder(160ug: 4.5ug)regularly(1 inhalation each time,2 times a day).After 1-year of follow-up,the number of acute exacerbations was recorded and the lung function and EOS% were reviewed.Compare the difference in the number of acute exacerbations 1 year before hospitalization and 1 year of follow-up between the A and B groups.Compare the changes in lung function of patients from the 7th day of hospitalization to the end of follow-up.The stability of blood eosinophils as a marker of COPD inflammation was analyzed.Results There was no significant difference in CAT?percutaneous oxygen saturation?CRP among the four groups before treatment(P>0.05).CAT?percutaneous oxygen saturation?CRP after treatment:There was significant difference between group A1 and group A2(P<0.05);There was no significant difference between group B1 and group B2(P>0.05);There was significant difference between group A1 and group B1(P<0.05);There was no significant difference between group A2 and group B2(P>0.05);There was a significant difference in CAT?percutaneous oxygen saturation?CRP before and after treatment(P<0.05).There was a statistically significant difference in hospitalization days between group A1 and group A2(P<0.05);There was no significant difference in hospitalization days between group B1 and group B2(P>0.05);There was a statistically significant difference in hospitalization days between group A1 and group B1(P<0.05);There was no significant difference in hospitalization days between group A2 and group B2(P>0.05).There was no significant difference in lung function between group A and group B before and after follow-up(P>0.05).There was a significant difference in lung function before and after follow-up(P<0.05).There was a statistically significant difference in the number of acute exacerbations between group A and group B berfore follow-up(P<0.05),but there was no significant difference after follow-up(P>0.05);There was a significant difference in the number of acute exacerbations before and after follow-up(P<0.05).The stability of eosinophils:After 3 times(day 1st,day 7th,after 1year)mesured,the percentage of patients whose EOS% remained above 2% or remained below 2% is 54.38%;Correlation between Fe NO and EOS%:Fe NO was positively correlated with EOS% before treatment(rs=0.798,P<0.01).Conclusion Blood eosinophils have predictive value for hormone therapy in patients with acute exacerbation of chronic obstructive pulmonary disease.Patients with higher eosinophils have better effects with hormone therapy;The short-term stability of blood eosinophils as a biomarker for COPD is acceptable.