| ObjectiveAnalyze the inflammatory factors,pulmonary function indexes,acute exaoerbation times,cortisd dose,OOPD complications,mortality and other clinical characteristics of patients with different BMI,mainly ecplcre the relationship between BMI and OOPD patients,and analyze the impact of BMI an the cocurrence,develooment and prognosis of OOPD patients.To provide a reference for clinicians in reasmable treatment of OOPD patients.Methods:A total of 285 OOPD patients admitted to the Department of Reepiratory Medicine of the First Affiliated Hospital of Nanchang University from January 2015 to January 2016 were selected aoocrding to the diagnostic criteria of Gold 2017 edition of OOPD.Collected into the crowd’s basic information(sex,age,height and weight),smoking history,complications,laboratory blood tests-white blood cells(WBC),nautrophil peroentage,c-reactive protein(CRP)and interleukin 6 and tumor neorosis factor,lung function,forced expiratory volumein 1 second(after bronchodilator FEV1),Forced expratory vital capacity(FVC),peak expiratory flow(PEF)and carbon monoxidediffusion capacity(DLOO),systemic cortiocsterod dose,and length of hospital stay.All enrdled patients were followed up by telephone and the hospital record system torecord moderate and severe acute exaoerbations ainoce the diagnosis of OOPD.Acocrding to World Health Organization(WHO)criteria,all participants were divided into three subgroups:low BMI group(BMI<18.5kg/m2),normal BMI group(18.5kg/m2≤BMI<23.9kg/m2),high BM group(24kg/m2≤BMI<28 kg/m2).The general data of different BMI groups were compared,and the number of acute exacerbations,cortisd dose and last hospital stay in different BMI groups were compared within 3 years.Spearman bivariate correlation was used to study the correlation between BMI and each index.Mann-Whitney U test was used to compare the relationship between inflammatory indexes and major parameters of lung function in different BMI groups.Binary logistic regression was used to analyze the relationship between OOPD complications and BMI,smoking history,gender and other factors.Kruskal-Wallis test was used to analyze the relationship between BMI and various indicators.Univariate Ocx regression analysis was performed to analyze the relationship between BMI and OOPD survival,and Kaplan-Meier curves were plotted.P values<0.05 indicates statistical significance.Results:1.There were no significant differences in age,gander,ODPD course and smoking history among different BMI groups(P>0.05).2.There were overall differences in the number of OOPD acute exacer bations,the last hospital stay,and the cortisd dose among different BMI grops(P<0.05),the number of acute exaoerbations,the last hospitalization time and cortisd dose in 3 years in low BMI group were significantly higher than those in normal BMI groip and high BMI group(P<0.05).3.IL-6,CRP,TNF and nautral ratio were significantly different among different BMI groups(P<0.05),IL-6,CRP,TNF and neutral ratio in low BMI group were significantly higher than those in normal BMI group and high BMI group(P<0.05).4.There were overall differences in FEV1%,PEF%and DLOO%among different BMI groups(FEV1%,PEF%and DLOO%in normal and high BMI groups were significantly higher than those in low BMI group(P<0.05).5.The higher the BMI of ODPD patients,the more likely they were to have hypertension(OR:255,3.46,P<0.05);The higher the BMI of OOPD patients,the more likely they were to have diabetes(OR 1.586,2.713,P:0.278,0.007,respectively).The higher BMI in OOPD patients,the mpre likely they were to have coronary heart disease(OR:2954,3.698,P<0.05);The higher the BMI in ODPD patients,the more likely they were to have OSHAS(OR=0.907,3.46,P=0.895,0.025,redectively).The lower the BMI in OOPD patients,the more likdy they were to haveost eoporosis(OR0.454,0.396,P:0.454,0.396,redectively).Thelower the BMI in OOPD patients,the more likely they were to have lung cancer(OR:0.5,0.433,P=0.048,0.045,respectively);6.Therisk of death in the low BNI group was significantly higher than that in the normal BMI group and the high BMI group(OR 0.23,0.19,P<0.05).Conclusion:1.OOPD patients with low BMI had more acute exaoerbations,longer hospital stays,and higher doses of cortisd.2.Patients with low BMI OOPD had higher levels of inflammatory cytckines.3.Patients with normal BMI had better indicators of lung function.4.Patients with low BMI ODPD aremorelikely tobe complicated with osteoporisis and lung cancer,while OOPD patients with high BMI are more likely to be complicated with hypertension,diabetes,hyperlipodemia and OSHAS.5.Patients with low BMI OOPD have a higher risk of death. |
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