Clinical Analysis Of Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease With Different Eosinophil Levels

Chronic obstructive pulmonary disease(COPD)is a kind of Chronic lung disease gradually known to the public,its incidence is related to many factors,so its pathogenesis is extremely complex,and it has the characteristics of irreversible,easy to relapse and aggravation,which makes the patients bear the dual damage of physiology and psychology.Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)lead to accelerated disease progression and a significant increase in mortality.Therefore,clinical medical staff should timely and accurately evaluate the severity of disease,treatment plan and clinical outcome of patients with AECOPD,and timely adjust those unsuitable treatment plans,so as to improve the quality of life and prognosis of patients with AECOPD.Objective:To analyze the clinical characteristics of AECOPD patients with different peripheral blood Eosinophils(EOS)levels and compare their differences,and to explore the value of peripheral blood EOS in guiding the disease assessment,clinical treatment and clinical outcome of AECOPD patients.Methods:Selecting 135 AECOPD patients from June 2019～June 2020.According to the EOS level of blood routine at admission,the research objects were divided into two groups,group I was high EOS level group(EOS ≥ 2%),group II was low EOS level group(EOS < 2%).Comparison group Ⅰ,Ⅱgeneral information(gender,age,smoking history,course of COPD,hormone use),complications(coronary heart disease,hypertension,diabetes),white blood cell count(WBC),neutrophil / lymphocyte(NLR),platelet /lymphocyte(PLR),procalcitonin(PCT),coagulation indexes(fibrinogen(FIB),D-dimer,fibrinogen degradation products(FDP)],Hemoglobin(HGB),sputum culture positive rate,blood gas analysis(oxygenation index,Pa CO2),mechanical ventilation rate and length of hospital stay.SPSS 21.0 software was used to analyze the general information of patients,the above laboratory tests,mechanical ventilation rate and length of stay,and to explore the value of EOS in guiding the condition evaluation,clinical treatment and clinical outcome of AECOPD patients.Results:This study included 135 patients as the research object,the group of patients with Ⅰ 53,it accounts for 35.26%,Ⅱ group with 82 cases patients,60.74%.(1)For group Ⅰ,Ⅱ patient’s gender,age,smoking history,course of COPD and hormone use,such as comparison,the result shows that it had no statistically significant differences(P > 0.05);(2)Contrast group Ⅰ,Ⅱ on the merger of coronary heart disease,high blood pressure,diabetes patients with differences had no statistical significance(P > 0.05);(3)The WBC、NLR、PLR、PCT、FIB、D-dimer、FDP level of group II patients was significantly higher than that of group I patients(P<0.05);There was no significant difference in the positive rate of HGB and sputum culture between group I and group II(P > 0.05).(4)Compared with the patients in group I,the oxygenation index of patients in group II was significantly reduced when they were admitted and discharged,and Pa CO2 was significantly increased,and the difference was statistically significant(P<0.05);while the oxygenation index and Pa CO2 of two groups of patients at discharge were improved,the difference was statistically significant(P < 0.05);after hospitalization,the changes of oxygenation index and Pa CO2 in group I were higher than those in group II,but the difference was not statistically significant(P > 0.05).(5)By mechanical ventilation rate,hospitalization days to reflect the outcome of patients,group ii patients with mechanical ventilation rate,hospitalization days were higher than group i,the difference was statistically significant(P<0.05).Conclusion:AECOPD patients with peripheral blood EOS < 2% have severe inflammatory reaction,lower oxygenation index and higher Pa CO2 partial pressure,suggesting that AECOPD patients with low EOS level had more severe condition,worse oxygenation and lung ventilation,and more obvious respiratory symptoms;AECOPD patients with peripheral blood EOS < 2%have higher coagulation index,which indicated that AECOPD patients with low EOS level have more severe hypercoagulable state and are more likely to form thrombosis;AECOPD patients with peripheral blood EOS < 2% have higher mechanical ventilation rate and longer hospitalization days,suggesting that the prognosis of AECOPD patients with low EOS level group was worse.In conclusion,the peripheral blood EOS has a certain reference value in guiding the condition evaluation,clinical treatment and clinical outcome of AECOPD patients.