伴嗜酸性粒细胞增高慢性阻塞性肺疾病急性加重期肺功能及影像学特征

Objective: To explore the characteristic differences of clinical data, inflammatory markers, pulmonary function test, impulse oscillometry system (IOS) and CT parameters of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with peripheral blood eosinophils (EOS) ≥300/μl and those EOS<300/μl, in order to provide strategic guidance for treatment. Methods: A total of 357 AECOPD patients were enrolled, including 41 cases in EOS≥300/μl group (study group) and 316 cases in EOS<300/μl group (control group).Then the clinical indicators, such as inflammation indicators from chronic obstructive pulmonary disease (COPD) assessment test (CAT) score and modified medical research council dyspnea scale (mMRC) assessment, traditional lung functions, IOS indicators, lung volume, emphysema index, emphysema density and other imaging parameters were compared between groups. Results: ①Neutrophils ratio in study group was lower than in control group (64.70% vs 73.00%, P<0.001), while fibrinogen lower (3.59 vs 3.97, P=0.031), C reactive protein lower (3.30 mg/L vs 8.63 mg/L, P=0.012) as well as smoking number lower (25 pack/years vs 40 pack/years, P=0.009) in study group were all lower than those in control group. ②RV/TLC in study group was lower than that in control group (51.91% vs 57.44%, P=0.041), whereas R5 (0.56 vs 0.49, P=0.036) and R5%pred (178.65% vs 155.70%, P=0.027) were higher in study group than those in control group. ③Mean pulmonary emphysema density and PD₁₅ in the whole lung, right lung and left lung in study group were all higher than those in control group (all P<0.05), suggesting that patients in control group had more serious pulmonary parenchymal destruction. Conclusion: AECOPD patients with EOS≥300/μl have more significant pulmonary function impairment due to increased airway resistance, in whom emphysema is less severe than those with EOS<300/μl.