Department of Respiratory Medicine, Huizhou third people's Hospital, Guangzhou Medical College, 1# Xuebei Ave, Huizhou, 516002, Guangdong, China.
BMC Pulm Med. 2020 Feb 24;20(1):50. doi: 10.1186/s12890-020-1086-1.
Measurement of sputum is frequently used to define airway inflammatory subtypes. The venous blood cell is a reliable and simple biomarker, may be used as an alternative procedure to reflect the subtypes. For the aim of verifying the hypothesis that venous blood cell can quantify sputum inflammatory cell to access the airway subtypes in chronic obstructive pulmonary disease of acute exacerbations (AECOPD) and to ascertain the accuracy of the blood cell biomarker.
This study evaluated 287 patients with COPD exacerbations and all four tests were performed on the same day, which are lung function test, bronchodilator reversibility test, sputum cell analysis and blood routine examination.
There was a correlation between sputum eosinophils and blood eosinophils, blood cells derived ratios. There was a weaker relationship to neutrophils between sputum and blood. Sputum neutrophils had not any association with neutrophil/macrophage ratio (NMR) and eosinophil/lymphocyte ratio (ELR) in blood. Blood eosinophils percentage was predictive for eosinophilic COPD exacerbations with an area under the curve (AUC) of 0.672 (p = 0.012). The optimum cutpoint for blood eosinophils percentage was 0.55%. Blood eosinophils absolute count was also predictive sputum eosinophilia at 0.35 × 10/L (AUC = 0.626, p = 0.025). ELR, eosinophil/monocyte ratio (EMR) and eosinophil/neutrophil ratio (ENR) in blood were higher in COPD exacerbations with mixed granulocytic and eosinophilic subtypes.
Eosinophils/neutrophils count parameters were relationship between blood and sputum. Eosinophils in blood and the ratios (ENR, EMR and ELR) may be utilized to assess eosinophilic airway inflammation in COPD exacerbations. Due to weak relationship and poor predictive ability, more researches should be required.
痰测量常用于定义气道炎症亚型。静脉血细胞是一种可靠且简单的生物标志物，可作为替代程序，反映亚型。目的是验证静脉血细胞可以定量痰液炎症细胞来评估慢性阻塞性肺疾病急性加重（AECOPD）的气道亚型，并确定血细胞生物标志物的准确性。
本研究评估了 287 例 COPD 加重患者，所有四项检查均在同一天进行，包括肺功能检查、支气管扩张剂可逆性试验、痰细胞分析和血常规检查。
痰嗜酸性粒细胞与血嗜酸性粒细胞、血细胞衍生比值存在相关性。痰中性粒细胞与血中性粒细胞的相关性较弱。痰中性粒细胞与血中性粒细胞/巨噬细胞比值（NMR）和嗜酸性粒细胞/淋巴细胞比值（ELR）无相关性。血嗜酸性粒细胞百分比对嗜酸性 COPD 加重具有预测作用，曲线下面积（AUC）为 0.672（p=0.012）。血嗜酸性粒细胞百分比的最佳截断点为 0.55%。血嗜酸性粒细胞绝对计数也可预测痰嗜酸性粒细胞，最佳截断值为 0.35×10/L（AUC=0.626，p=0.025）。血 ELR、EMR 和 ENR 在混合粒细胞和嗜酸性亚型 COPD 加重中较高。
血和痰之间存在嗜酸性粒细胞/中性粒细胞计数参数的关系。血中嗜酸性粒细胞和比值（ENR、EMR 和 ELR）可用于评估 COPD 加重时的嗜酸性气道炎症。由于相关性较弱和预测能力差，需要进一步研究。
