The Study On The Correlation Between Eosinophil Cationic Protein And Clinical Characteristics Of COPD

The first part-Correlation between eosinophils and clinical characteristics of acute exacerbation of COPDObjective:To investigate the relationship between eosinophil(EOS)and the average length of stay,the amount of glucocorticoid and the high sensitive C-reactive protein(hs CRP)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:The electronic medical records of 166 AECOPD hospitalized patients were collected from the First Affiliated Hospital of Soochow University and the Department of Respiratory Medicine of Lianyungang Second People's Hospital,the date from January 01,2014 to December 31,2019.According to the percentage of eosinophils in the peripheral blood at the time of admission,the patients were divided into a low eosinophil group(<2%)and a high eosinophil group(?2%).Mann-Whitey U test was used to compare the differences in mean hospital stay,glucocorticoid dosage,and high-sensitivity C-reactive protein between the two groups.COX regression was used to analyze the correlation between EOS%and the length of hospital stay.Kaplan-meier survival function was used to analyze the relationship of the proportion of patients discharged between the two groups.Results:(1)There were 43 patients with AECOPD whose EOS%was more than 2%,accounting for 25.9%,(2)The average length of hospital stay(day)in AECOPD patients with EOS%?2%in peripheral blood was significantly shorter(100.79±99.19 vs 149.37±130.72,p=0.04);blood EOS%?2%was an independent relevant factor for discharge of AECOPD patients;according to the K-M survival curve,the percentage of patients with blood EOS%?2%perday is significantly reduced than patients with EOS%<2%(p=0.001);(3)The average dosage of methylprednisolone(mg)was significantly reduced in patients with blood EOS%?2%(100.79±99.19 vs 149.37±130.72,p=0.04);(4)There was no significant difference in high-sensitivity C-reactive protein(mg/L)between AECOPD patients with blood EOS%?2%and blood EOS%<2%(8.23±9.72 vs 10.03±8.99,p=0.118).Conclusions:1.In patients with acute exacerbation of COPD,25.9%of them had EOS%?2%in peripheral blood2.AECOPD patients with blood eosinophils?2%,the average length of hospital stay is significantly shorter;3.In AECOPD patients with blood eosinophils?2%,the amount of glucocorticoids is relatively small,their response to glucocorticoids may be better.The second part-Correlation between eosinophil cationic protein and clinical characteristics of COPD diseaseObjective:To study the distinction of blood eosinophil cationic protein(ECP)level between AECOPD patients and stable COPD patients.Further explore the correlation between blood eosinophil cationic protein and clinical features of COPD.Methods:41 outpatients with stable COPD from the the Department of Respiratory Medicine of the First Affiliated Hospital of Soochow University,and 22 AECOPD patients from the First Affiliated Hospital of Soochow University and Suzhou Ninth People's Hospital,all patients were enrolled from May 2019 to December 2019.All patients finished pulmonary function tests and CAT scores.Collect blood samples from all patients and detect blood ECP levels by ELISA,The Mann-Whitey U test was used to compare the differences in ECP between AECOPD patients and stable COPD patients,the correlation between blood ECP and clinical characteristics of stable COPD patients and the correlation between arterial blood gas and ECP in AECOPD patients were explored by Spearman.Based on the CAT score(<10 points,?10 points),blood EOS%(<2%,?%2),FEV1%pred(grade 1-2,grade 3-4)and other indicators,the stable COPD patients were divided into different groups,the differences of ECP between the groups were analyzed by Mann-Whitey U test.Results:Finally 63 COPD patients were included,including 41 stable COPD patients and 22 AECOPD patients.(1)The ECP level(ng/ml)in AECOPD patients was higher than the level in stable COPD patients(22.70 ± 0.96 vs 14.08 P<0.001).(2)In AECOPD patients,the blood ECP level correlates with PaCO2(p=0.005,r=0.575).(3)In stable COPD patients,the less symptom,the higher ECP level(ng/ml)(15.7 ± 4.8 vs 11.8±3.8,P=0.009).(4)In stable COPD patients,the ECP level and EOS%have no correlation(P=0.261).(5)There was no correlation between ECP level and FEV1%pred in stable COPD patients(P=0.652);the ECP level in stable COPD patients has no difference between people with different pulmonary function grades(P=0.232).(6)In stable COPD patients,the blood ECP level and CRP have no correlation(p=0.689).Conclusions:1.The eosinophil cationic protein increased in AECOPD patients,which may be a biomarker of AECOPD.2.PaCO2 correlates with eosinophil cationic protein in AECOPD patients.3.The stable COPD patients with few clinical symptoms have a high level of eosinophil cationic protein.4.Eosinophil cationic protein didn't correlate with pulmonary function?percentage of eosinophils and C-reactive protein in stable COPD patients.