Clinical Characteristics Of Combined Pulmonary Fibrosis And Emphysema

ObjectiveWe retrospectively studied the general data,clinical symptoms,laboratory test indicators,imaging manifestations,pulmonary function,and arterial blood gas analysis of patients with Combined pulmonary fibrosis and emphysema （CPFE）,summarizing the clinical features of the disease,strengthening clinicians’awareness of the diagnosis of the disease。The purpose is to prevent missed diagnosis,misdiagnosis and improve the quality of life of patients.MethodWe collected the patients with interstitial lung disease admitted to the Department of Respiratory Medicine,China-Japan Union Hospital of Jilin University from January 2018 to December 2021,according to the inclusion and exclusion criteria,a total of 43 patients in the CPFE group and 50 patients in the IPF group were screened out.Their data of gender,age,smoking history,smoking index,clinical symptoms （cough,expectoration,dyspnea,etc.）,physical signs（Velcro rales,clubbing fingers）,white blood cell count,procalcitonin,C-reactive protein,tumor markers,arterial blood gas analysis indicators,pulmonary function,whether combined with pulmonary hypertension,whether combined with lung cancer and other data.Statistical analysis of the collected data was performed using SPSS 26.0 statistical analysis software.Results1.There were more males than femalesin both groups.The smoking index in the CPFE group was higher than that in the IPF group,and the difference was statistically significant（P=0.005）.2.The symptoms of cough and dyspnea in CPFE group were more than those in IPF group（P=0.043,P=0.016）,and the difference was statistically significant.3.The PO₂of the patients in the CPFE group was lower than that in the IPF group,P=0.002,and the difference was statistically significant.4.Comparing the pulmonary function-related indicators between the two groups:the TLC in the CPFE group was higher than that in the IPF group,and the difference was statistically significant（P=0.035）.The mean values of FEV1,FEV1%, FEV1/FVC%,and DLCO in the CPFE group were lower than those in the IPF group,and the differences were statistically significant（P=0.004;P=0.000;P=0.001; P=0.027）.And restrictive ventilatory dysfunction was the main problem in both groups.5.The CPFE group had more pulmonary hypertension than the IPF group,P=0.035,there was statistical significance between the two groups.And patients with CPFE groups are more likely to combine high-pressure pulmonary hypertension.Conclusion1.Most of CPFE patients have a long-term massive smoking history.2.The most prominent clinical manifestation of CPFE is dyspnea.Compared with pure IPF,the PO₂of CPFE syndrome is lower,and the demand for oxygen is not consistent with the pulmonary ventilation function,and the typical pulmonary function features of CPFE syndrome are markedly decreased diffusing function.3.The incidence of pulmonary hypertension in CPFE patients was higher than that in IPF group.