Inflammation increases during exacerbations of COPD and there are changes in sputum and hematic cells profile. Better identification of these changes will increase our knowledge and potentially guide therapy. The aim of this study was to investigate sputum and hematic cell profile in EACOPD. In this study, 56 AECOPD patients have been evaluated at first consultation, and after 21 days in relation to the number of sputum inflammatory and hematic cells.

In AECOPD there is significant growth of cellular sputum elements, with predominance of macrophages and neutrophils, compared with their content 21 days after. Cellular stratification in the sputum of patients with AECOPD resulted predominantly of neutrophilic and paucigranulocytic type. Leukocytosis in the blood coincides with AECOPD and the number has decreased with the return in stable condition. Neutrophil/lymphocyte ratio (NLR) results a significant indicator to detect acute exacerbations of COPD, and to evaluate recovery. Diagnosis of AECOPD is supported by increased sputum inflammation as proxy of airways inflammation, and increased systemic inflammation as demonstrated by increased number of blood cells.

Background: Inflammation increases during exacerbations of COPD and there are changes in sputum and hematic cells profile. Better identification of these changes will increase our knowledge and potentially guide therapy.

Aim: The aim of this study was to investigate sputum and hematic cell profile in AECOPD.

Methods: There is a prospective study conducted in Regional Hospital, Fier. There are enrolled patients with stage III and IV of COPD in AECOPD condition.  In this study, 56 AECOPD patients have been evaluated at first consultation, and after 21days in relation to the number of sputum inflammatory and hematic cells. All of the AECOPD patients were stratified, according to the number of neutrophils (>61%) and eosinophils (>2.5%) in the sputum samples. Individual patients were classified into the eosinophilic (EO) with sputum eosinophils >2.5% of total cells, the neutrophilic (NE) with neutrophils >61%, the paucigranulocytic COPD (PA) with eosinophils ≤2.5% and neutrophils ≤61%.

The examination specimen was an early–morning spontaneously produced sputum, after the deep breathing followed by strong cough. Depending on the cells, which are seen in the sputum judged whether it is received or not satisfactory specimen. If there are sufficient quantities of macrophages is understood that we are dealing with sputum, not with saliva. If the cellular elements that dominate are squamous cells, or Candida and ciliated epithelial cells, we are dealing with oral or sinonasal elements.

Hematological examination was conducted with Sysmex XS–100i Automated Hematology Analyzer, by fluorescent cytometry.