Predictive values of sputum ECP and IL-8 for patients with acute exacerbation of chronic obstructive pulmonary disease with different EOS classification
Objective To investigate clinical predictive values of sputum eosinophil cationic protein(ECP)and interleukin-8(IL-8)for patients with elevated eosinophil(EOS)acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and patients with non-EOS AECOPD.The patients with AECOPD were classified by EOS percentage and absolute value,and the differences in clinical characteristics and inflammatory indicators were analyzed between these classified patients.Methods A total of 72 AECOPD inpatients were divided into non-elevated type 1 group(EOS％＜2％)and elevated type 1 group(EOS％≥2％)based on the percentage of EOS(EOS％).According to the absolute value of EOS(|EOS|),they were divided into non-elevated type 2 group(|EOS|＜105/L)and elevated type 2 group(|EOS|≥105/L).t-test,rank sum test and x2 test were used to compare the differences in sputum ECP,IL-8,clinical characteristics and inflammatory indexes in peripheral blood between AECOPD patients with different EOS classifications.Spearman correlation was used to analyze the association of peripheral blood EOS with inflammatory indexes,sputum ECP and IL-8.ROC curve was used to evaluate the predictive values of sputum ECP,IL-8,and inflammatory indicators in peripheral blood for AECOPD with different EOS classifications.Results Under the same classification,non-elevated type 1 and type 2 groups had neutrophil(NEU),percentage of neutrophil(NEUR),neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),fibrinogen-albumin ratio(FAR),C-reactive protein(CRP),fibrinogen(FIB),sputum IL-8,the times of acute exacerbations in the past year,modified Medical Research Council(mMRC)score and COPD assessment test(CAT)higher than elevated type 1 and type 2 groups had(P＜0.05),while their LYM,LYM％,and sputum ECP were lower than those of elevated type 1 type 2 groups.White blood cell(WBC)was higher in non-elevated type 1 group than that in elevated type 1 group(P＜0.05).There was no significant difference in WBC level between non-elevated type 2 group and elevation type 2 group(P＞0.05).Peripheral blood EOS was positively correlated with sputum ECP,and negatively correlated with sputum IL-8,peripheral blood NLR,NEU,NEUR,CRP,PLR and FAR(P＜0.05).ROC curve analysis suggested that the predictive values of sputum ECP and IL-8,peripheral blood NLR,CRP and FAR for different EOS classification of AECOPD were statistically significant(P＜0.05).Conclusion Clinical symptoms and inflammatory response of inpatients with non-elevated EOS AECOPD are more severe than those of inpatients with elevated EOS AECOPD,and they are more prone to bacterial infection.Sputum ECP,IL-8,and inflammatory indexes in peripheral blood have certain value in classifying AECOPD patients.
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