Objective To observe the short term efficacy of budesonide/formoterol and glucocorticoid(GC)in the treatment of eosinophilic(EOS)hyperplasia and non-EOS hyperplasia acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods The clinical data of 168 patients with AECOPD treated and treated by the respiratory Depart-ment of the General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army from June 2020 to June 2023 were analyzed.According to the EOS ratio,they were divided into the EOS increased phenotype group(EOS＞2％,n=42)and the non-EOS increased phenotype group(EOS≤ 2％,n=126).The EOS proliferation phenogroup was randomly divided into subgroup Ⅰ(n=21)and subgroup Ⅱ(n=21),and the non-EOS proliferation phenogroup was randomly divided into subgroup Ⅲ(n=63)and subgroup Ⅳ(n=63).Subgroups Ⅰ and Ⅱ were given budesonide/formoterol inhalation thera-py,and subgroups Ⅱ and Ⅳ were given oral or intravenous glucocorticoid(GC)therapy.Venous blood EOS count,blood gas analysis index[PaO2/FiO2,arterial partial pressure of carbon dioxide(PaCO2)],Chronic obstructive pulmonary disease Evaluation Test Scale(CAT)score and length of stay were compared at admission and 5 days after treatment.Results Af-ter 5 days of treatment,the EOS count in venous blood of subgroup Ⅰ and subgroup Ⅱ was lower than that at admission,and the EOS count in venous blood of subgroup Ⅱ was lower than that in subgroup Ⅰ(t/P=2.641/0.012).After 5 days of treatment,the PaO2/FiO2 of subgroup Ⅱ was higher than that of subgroup Ⅰ,and the PaCO2 and CAT scores were lower than those of subgroup Ⅰ(t/P=4.331/＜0.001,3.351/0.002,2.884/0.006).There was no significant difference in PaO2/FiO2,PaCO2 and CAT scores between subgroup Ⅲ and subgroup Ⅳ(P＞0.05).After 5 days of treatment,the PaO2/FiO2 combi-nation in subgroup Ⅰ was higher than that in subgroup Ⅱ(t/P=8.856/＜0.001,6.588/＜0.001,1.964/0.049),the PaCO2 and CAT scores were lower than those in subgroup Ⅲ,the PaO2/FiO2 scores in subgroup Ⅱ were higher than those in sub-group Ⅳ,and the PaCO2 and CAT scores were lower than those in subgroup Ⅳ(t/P=12.456/＜0.001,10.350/＜0.001,5.356/＜0.001);The length of hospitalization in subgroup Ⅱ was shorter than that in subgroup Ⅰ(t/P=2.718/0.010).The length of stay in subgroup Ⅰ was shorter than that in subgroup Ⅱ(t/P=4394/0.010),and the length of stay in subgroup Ⅱ was shor-ter than that in subgroup Ⅳ(t/P=6.700/＜0.001).Conclusion In patients with EOS increased phenotype AECOPD,the short-term efficacy of GC systemic administration is better than budesonide/formoterol aerosol inhalation,while in non-EOS in-creased phenotype AECOPD patients,the short term efficacy of aerosol inhalation therapy is similar to GC systemic adminis-tration,and aerosol inhalation therapy can replace GC systemic administration.
Acute exacerbation of chronic obstructive pulmonary diseaseEosinophilic granulocyte phenotypeBudesonide/FormoterolGlucocorticoidAtomizing inhalationSystemic applicationTherapeutic effectEosinophilsBlood gas analysis
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