Correlation Between Eosinophil Levels And Severity Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To study peripheral blood eosinophil level can be used as a biological indicator to evaluate the severity of acute exacerbations of chronic obstructive pulmonary disease.Methods: The study samples were collected from the hospitalized cases admitted to our department of respiratory medicine in our hospital from 2014.01 to 2017.12,diagnosed as Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD),excluding active tuberculosis,lung cancer,bronchiectasis,bronchial asthma,allergic rhinitis,interstitial Sexual lung disease and those cases that can not carry out the lung function test due to various reasons.The study data includes general conditions(such as age,gender,smoking history),signs(such as mean arterial pressure,heart rate),combined underlying diseases(hypertension,diabetes,coronary heart disease),laboratory indicators(white blood cells,albumin,urea nitrogen,creatinine),PCT,CRP,NAP,blood gas analysis PH value),lung function(FEV1% predicted value),CAT score,whether to use ventilator-assisted ventilation during hospitalization,whether pulmonary hypertension and respiratory failure,hospitalization days,telephone follow-up patients discharged 1 The number of acute exacerbations during the year.(1)According to whether the peripheral blood eosinophils(EOS)measured at the time of enrollment were >2% as a cut-off point,they were divided into EOS>2% group and EOS?2% group.The indicators reflecting the severity of AECOPD between the two groups,such as lung function,inflammation index,CAT score,complications,whether ventilator-assisted ventilation,and hospitalization days were statistically significant.(2)According to the telephone follow-up,the number of acute exacerbation risks within one year after discharge was divided into two groups: low-risk group(?1)and high-risk(>1).Firstly,the factors that may affect the risk of recurrence of acute exacerbation were selected,and the risk of acute exacerbation was taken as the dependent variable.The EOS and other indicators of peripheral blood were used as independent variables.Logistic regression of binary multivariate analysis was used to analyze whether EOS level of peripheral blood was affecting AECOPD.The patient's risk of recurring acute exacerbations.Results: A total of 270 patients were enrolled in the study,including 114 patients with peripheral blood EOS>2%,156 patients with peripheral blood EOS?2%,223 patients with low risk,and 47 patients with high risk.(1)Two groups of patients(peripheral blood EOS ? 2% group and peripheral blood EOS > 2% group)in patients with pulmonary hypertension(36.5% VS 34.2%,P <0.01),respiratory failure(37.8% VS 26.3%,P=0.047).The difference between ventilator-assisted ventilation(17.3% VS 5%,P=0.003),CAT score(23 VS 16,P<0.01),and hospital stay(10 VS 9,P=0.036)was statistically significant.Peripheral blood EOS levels were correlated with PCT,CRP,NAP,and pulmonary function grading(FEV1% predicted value).The results showed that peripheral blood EOS levels were correlated with PCT(r=-0.22,P=0.005)and CRP(r=-0.214,P < 0.001),NAP(r =-0.277,P < 0.001),and lung function grading(r =-0.115,P = 0.029)were negatively correlated.(2)Screening for factors that may affect the risk of recurrent acute exacerbations(P<0.05),and found that patients with AECOPD were respiratory failure(P=0.022),mean arterial pressure(P=0.039),and peripheral blood EOS(P=0.033).Recurrence of risk factors associated with acute exacerbation,followed by low-risk group or high risk as the dependent variable,respiratory failure,mean arterial pressure,peripheral blood EOS as an independent variable,binary multivariate logistic regression analysis,the results showed peripheral blood EOS levels were not a factor in the risk of recurrence of acute exacerbations in AECOPD patients(P=0.054).Conclusion: Patients with peripheral blood eosinophils ? 2% have a higher inflammatory response,higher CAT score,poor lung function,longer hospital stay,higher respiratory failure,higher pulmonary hypertension,and more use of ventilator assisted Breathing,it can be speculated that the peripheral blood EOS level can be used as an indicator to judge the condition of COPD.However,peripheral blood EOS levels do not predict the risk of recurrent acute exacerbations in AECOPD patients.