Comparative Study Of Inflammatory Markers In Peripheral Blood Between COPD With Asthma And COPD Alone

Background Chronic obstructive pulmonary disease(COPD)and asthma(AS)are common chronic airway diseases in the respiratory system.COPD is irreversible airflow limitation with cough,expectoration or dyspnea as the main symptoms,while AS is more likely to have symtoms at night and in the morning with reversible airflow limitation,which is easy to distinguish in clinic.But more and more patients have the characteristics of these two diseases at the same time,and the symptoms are more severe,the acute exacerbation is more frequent,and the cost is higher,which brings huge burden to the society and the families.At present,the mechanism and phenotype of COPD with AS are still unclear,but similar to COPD or AS,it is a chronic airway inflammatory disease in nature.There are still pathophysiological characteristics such as airway inflammation and airway remodeling in the progress of the disease,involving a variety of inflammatory factors.To seek effective and convenient inflammatory markers is the current research hotspot.Objective This study compared the inflammation markers in peripheral blood and lung function indexes between COPD with AS and COPD,and explored the expression differences of IL-33,IL-17 and IL-10 in the two grops,in order to find effective serum inflammatory markers and provide some help for the diagnosis and treatment of COPD with AS.Methods A total of 43 patients with COPD with AS acute exacerbation and 41 patients with COPD acute exacerbation alone who were admitted to our hospital from December 2019 to February 2021 were included.General data,hematological data,pulmonary function and other clinical data were collected.T test and Mann Whitney U test were used to compare the measurement data,Chi Square test was used to count data,partial correlation test was used to analyze the correlation of data,and binary logistic regression analysis and ROC curve were used to verify the diagnostic efficacy of inflammatory indicators,with P<0.05 as the difference was statistically significant.Results(1)The leukocyte count,eosinophil count,percentage of eosinophils,CRP and FIB in COPD with AS group were higher than those in COPD group(P<0.05);(2)IL-33 and IL-17 in COPD with AS group were higher than those in COPD group(P<0.05);(3)FEV1 and FEV1/FVC in COPD with AS group were lower than those in COPD group(P<0.05);(4)in the two groups,FIB was negatively correlated with FEV1,FEV1/FVC,FEF50(P<0.05),IL-33 and IL-17 were negatively correlated with FEV1,FEV1/FVC,FEF50 and PEF(all P<0.05),while IL-10 was positively correlated with FEV1,FEV1/FVC,FEF50 and PEF(all P<0.05).(5)IL-33 had the highest specificity(51.2%)in the diagnosis of COPD with As,and IL-33 combined with IL-17 had the highest sensitivity(81.4%)in the diagnosis of COPD with As,but their area under the curve(0.631 vs 0.632)were lower.Conclusion(1)Compared with COPD group,the level of inflammation in COPD with AS group was higher,and lung function index decreased more dramatically;(2)In COPD with AS group,FIB,IL-33 and IL-17 were negatively correlated with FEV1 and FEV1/FVC,while IL-10 was positively correlated with FEV1,FEV1/FVC,FEF50 and PEF;(3)The detection of IL-33,IL-17,IL-33 combined with IL-17 can be used as the differential index between COPD with AS group and COPD group,but the differential value is low.