Objective  To investigate the correlation between inflammatory cell phenotype and clinicopathologic features in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods  200 patients with AECOPD admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University were included as research subjects. According to the peripheral blood cell count results, the patients were divided into neutrophilic inflammatory phenotype group (NE group, n=120) and eosinophilic inflammatory phenotype group (EOS group, n=80). Airway inflammatory markers: FeNO, small airway/alveolar nitric oxide (CaNO), pulmonary function indicators (FVC, FEV1, FEV1/FVC), respiratory function (WOB, Raw, MVV) of patients in NE group and EOS group were detected, respectively, the clinical diagnosis and treatment, and clinical prognosis of the two groups were compared.

Results  FeNO and CaNO indexes in NE group were significantly higher than those in EOS group (P<0.05). The values of FVC, FEV1 and FEV1/FVC in NE group were lower than those in EOS group (P<0.05). WOB and Raw in NE group were higher than those in EOS group (P<0.05), and MVV in NE group was lower than that in EOS group (P=0.009). The proportion of patients with frequent COPD exacerbation, the proportion of patients with purulent sputum cough, the proportion of combined antibiotic users and the proportion of non-invasive ventilator users in NE group were higher than those in EOS group (P<0.05), the acute physiology and chronic health evaluation (APACHE) score of NE group was higher than that of EOS group (57.34±3.23 vs. 45.36±3.28, P=0.004). The incidence of poor clinical outcomes in NE group was significantly higher than that in EOS group (15.00% vs. 5.00%, P=0.010).

Conclusion  The degree of airway inflammation, the degree of lung function and respiratory dysfunction, the basic clinical symptoms and the disease of NE-type AECOPD patients are more serious than those of EOS-type AECOPD patients, and patients with NE-type AECOPD have a higher incidence of poor prognosis than those with EOS.

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