Exploration Of COPD Patients With Different Phenotypes Based On Dual Gas Phase Quantitative CT Correlation Between Sleep Quality And Inflammation Level

Objective:To explore the correlation between sleep quality and inflammation levels in COPD patients with different imaging phenotypes,to provide a theoretical basis for the comprehensive assessment of COPD and individualized treatment of COPD.Materials and methods:We selected 124 patients with AECOPD who were hospitalized in the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of Yan’an University who met the criteria for inclusion and exclusion from November 2019 to December 2020.Bi-gas quantitative CT was performed on patients who met the inclusion criteria by cluster analysis,the subjects were divided into three groups,Group 1 was a small gas phenotype(A-type),Group 2 was an emphysema phenotype(E-type),Group 3 was mixed(M-type).Complete data collection and recording for all subjects,include general information(age,sex,course of BMI,smoking index,number of acute exacerbations in the previous year),inflammatory indicators(WBC、N%、NLR、EOS、hs-CRP、PCT),PSQI score.The observation index was statistically analyzed and processed.Analysis of the difference in COPD sleep quality and inflammatory level between three different phenotypes and their correlation.Results:1.The data measured by dual gas-phase quantitative CT are analyzed by statistical method(k-means classification method).The subjects were divided into three groups.There are 56 cases in Group 1(A-type),41 cases in Group 2(E-type),and 27 cases in Group 3(M-type).2.Comparison of general clinical data:124 cases was included in this study.Among them,A-type 56,the age distribution is 70.45±8.15 years,the gender ratio is 47/9;E-type41,the age distribution is 69.86±8.49 years,the gender ratio is 28/13;M-type 27,the age distribution is 67.22±9.21 years,the gender ratio is 21/6.Three different phenotypes,the ratio of age,sex composition,BMI,smoking index and acute exacerbation in the previous year P>0.05.In the course of COPD,it was found that the duration of type A was longer than that of type E,P<0.05.3.Comparison of inflammatory levels among patients with three phenotypes: The inflammatory levels among patients with three different phenotypes of COPD were pairwise compared between WBC,EOS and PCT,P > 0.05.In a pairwise comparison between N%,NLR,and hs-CRP,the N% of patients with type E is higher than those with type A and M,P<0.05;NLR in patients with type E is higher than that of type M,P<0.05;the hs-CRP in type A patients was lower than that of type E and type M,P<0.05.4.Comparison of sleep quality among patients with three phenotypes: Pairwise comparison of sleep quality among patients with three different phenotypes of COPD showed that P < 0.05 was found in the comparison of sleep quality between patients with E-type,A-type,and M-type.Respectively,indicating that there were more sleep disorders among patients with E-type COPD than patients with A-type and M-type.The sleep quality of A-type COPD patients was mainly high,accounting for 60.7%;the sleep quality of type E-type COPD patients was mainly low,accounting for 75.6%;there was no significant difference in the number composition between the low sleep quality group and the high sleep quality group in the M-type COPD patients.5.Correlation between sleep quality(PSQI score)and inflammation level in three phenotypes: there is a certain correlation between sleep quality and inflammation level COPD three different phenotypes.Of the A-type COPD patients,PSQI score was weakly positively correlated with N%,positively correlated with NLR and negatively correlated with EOS.Patients with E-type COPD had a stronger correlation between PSQI scores and inflammatory markers,there was a strong positive correlation between PSQI score and N%、NLR、hs-CRP,a strong negative correlation with EOS;Of M COPD patients,there was a strong positive correlation between PSQI score and hs-CRP,and EOS medium negative correlation.Conclusion:Patients with different phenotypes of COPD have different sleep quality and inflammation level,the higher the PQI score,the higher the inflammation level.Emphysema phenotype have more serious sleep disorders and inflammation level than airway phenotype,patients with mixed phenotype.