Study On The Relationship Between Peripheral Blood Eosinophil Levels And Progressive Fibrotic Interstitial Lung Disease

Objectives:In this study,peripheral blood eosinophil related data of PF-ILD patients were collected retrospectively.We analyzed the expression level of peripheral blood eosinophils in patients with PF-ILD,and explored its relationship with the severity of the disease and its clinical diagnostic value.Methods:Clinical data of patients with interstitial lung disease were collected.The ILD patients were divided into PF-ILD group and Non-PF-ILD group.Detailed information on general clinical data,peripheral blood eosinophil levels and other relevant laboratory indexes,pulmonary function indexes,and imaging indexes of the patients were recorded.Comparative analysis:(1)The general clinical data,eosinophil levels,relevant laboratory indexes,pulmonary function and imaging related indexes of the two groups were compared and analyzed.(2)The correlation between eosinophil levels and observation indicators was analyzed.(3)Logisitic regression analysis was used to explore the influencing factors of PF-ILD.(4)The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of peripheral blood eosinophil levels for PF-ILD.Results:(1)Comparison of general data:In comparison with patients in the Non-PF-ILD group,patients in the PF-ILD group were older and the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups in terms of gender,disease duration,smoking history,type of primary disease and treatment regimen.(2)The difference analysis between the two groups:the level of peripheral blood eosinophils in the PF-ILD group was higher than that in the Non-PF-ILD group(P<0.05);the expression levels of monocytes,leukocytes,high-sensitivity C-reactive protein,Erythrocyte sedimentation rate,IL-6,CEA,and TNF-αin the PF-ILD group were higher than those in the Non-PF-ILD group(P<0.05),and there was no significant difference in IL-4,IL-17,IL-10,CA199,CA125 and CA153 between the two groups(P>0.05);the FVC%pred,FEV1%pred and DLCO%pred in the PF-ILD group were significantly lower than those in the Non-PF-ILD group(P<0.05),while TLC%pred was not statistically significantly different between the two groups(P>0.05);HRCT scores were higher in the PF-ILD group than in the Non-PF-ILD group(P<0.001).There was no statistically significant difference in PASP levels between the two groups(P>0.05).(3)Correlation analysis:The level of peripheral blood eosinophil in PF-ILD patients was negatively linked to lung function indexes such as FVC%pred,FEV1%pred TLC%pred and DLCO%pred(r=-0.278、-0.280、-0.351、-0.317,P<0.05),and was positively related to imaging Indexes such as HRCT score(r=0.284,P=0.013)and PASP levels(r=0.256,P=0.026).The level of peripheral blood eosinophil in PF-ILD patients was also positively associated with inflammatory indicators such as IL-6(r=0.262,P=0.022)and TNF-α(r=0.231,P=0.045).(4)Multivariate logistic regression analysis:elevated absolute eosinophil values,elevated absolute monocyte values and elevated HRCT scores were independent risk factors for PF-ILD.(5)ROC curve was used to evaluate the diagnostic value of peripheral blood eosinophil for PF-ILD:The area under the curve of peripheral blood eosinophil for the diagnosis of PF-ILD was 0.774(P<0.001),and the sensitivity was 55.3%,the specificity was 89.5%.The best cut-off value for the diagnosis of PF-ILD is0.575×10~9/L.Conclusions:(1)The peripheral blood eosinophil levels are increased in patients with PF-ILD,which is related to poor lung function and severe pulmonary fibrosis.(2)The peripheral blood eosinophil levels has a certain value in the diagnosis of PF-ILD.(3)The increase of peripheral blood eosinophil levels is an independent factor for the progression of pulmonary fibrosis in patients with ILD.