Predictive Value of Peripheral Blood Eosinophil Count for the Effect of Hormone Therapy in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

doi:10.3969/j.issn.1674-3245.2025.03.035

Abstract：Objective To analyze the predictive value of peripheral blood eosinophil (EOS) count for the therapeutic effect of hormone therapy in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 74 patients with AECOPD admitted to Mengcheng County Second People's Hospital from November 2021 to November 2023 were enrolled. According to their EOS levels upon admission, patients were divided into two groups: the EOS elevated group (≥ 300/μl) and the non-elevated group (< 300/μl). Both groups received hormone therapy. The hospitalization duration, hormone dosage, and daily hormone usage were compared between the two groups. Additionally, differences in C-reactive protein (CRP), rates of invasive and non-invasive mechanical ventilation, oxygenation index, and blood gas analysis results were analyzed. Results The hormone dosage, hospitalization duration, and daily hormone usage were all lower in the EOS elevated group compared to the non-elevated group [(192.36±25.88) mg vs. (341.45±37.52) mg, (8.73±1.82) days vs. (10.25±2.68) days, (28.21±12.33) mg/day vs. (37.35±16.49) mg/day], with statistically significant differences (t=19.896, 2.854, 2.700, P<0.05). The rates of non-invasive and invasive mechanical ventilation in the EOS elevated group (2.7% and 0.0%, respectively) were lower than those in the non-elevated group (16.22% and 5.41%, respectively), with a statistically significant difference in the non-invasive mechanical ventilation rate (t=3.945, P=0.047). After 7 days of treatment, the oxygenation index (370.53±51.41) and arterial oxygen partial pressure (77.32±7.17) in the EOS elevated group were higher than those in the non-elevated group (324.86±69.57 and 70.11±8.25, respectively), with statistically significant differences (t=3.211, 4.012, P<0.05). Conclusion Patients with AECOPD and peripheral blood eosinophil counts > 300/μl show a better response to hormone therapy, with shorter treatment duration and lower hormone dosage. Blood eosinophil levels can serve as a biomarker to guide glucocorticoid therapy in patients with AECOPD.