Correlation Analysis Of Imaging Parameters And Cardiopulmonary Function In Non-Smoking COPD Patients

Objective: The differences of clinical data between NS-COPD patients(non-smoking COPD patients)and S-COPD patients(smoking COPD patients)were retrospectively analyzed and compared,and the correlation between chest CT parameters(LAA%)and cardiopulmonary function was discussed.Finally,the clinical characteristics of NS-COPD were comprehensively analyzed.Methods: Patients diagnosed with COPD admitted to the Department of Respiratory and Critical Care Medicine,Yijishan Hospital Affiliated to Wannan Medical College from October 2018 to December 2022 were collected.After relevant screening,102patients(including 54 in the smoking group and 48 in the non-smoking group)were included in this study.The collected data are as follows: General clinical data included sex,age,smoking history,BMI(body mass index),environmental exposure factors(including long-term passive smoking history,biofuel smoke exposure,cooking fume inhalation,occupational dust exposure);Laboratory blood test data included red blood cell count,red blood cell distribution width,mean red blood cell volume,white blood cell count,hemoglobin,platelets,CRP,total bilirubin,uric acid,alanine aminotransferase,aspartate aminotransferase,BNP(brain natriuretic peptide),D2 polymers,fibrinogen;The parameters of lung function include FVC(forced expiratory volume),FEV1(forced expiratory volume in the first second),FEV1/FVC(percentage of forced expiratory volume in forced expiratory volume in the first second),PEF(peak expiratory flow),MEF50(maximum expiratory flow rate of 50% vital volume)and BF(respiratory rate).Left ventricular ejection fraction and inner diameter of echocardiography included LEVF(left ventricular ejection fraction),LVD(left ventricular diameter),LAD(left atrial diameter),RVD(right ventricular diameter)and RAD(right atrial diameter).Quantitative parameters of chest CT included left lung LAA%(left lung low-density area volume percentage),right lung LAA%(right lung low-density area volume percentage),and whole lung LAA%(whole lung low-density area volume percentage).Firstly,they were divided into smoking group and non-smoking group according to whether they smoked or not.General clinical data and laboratory blood test data between the two groups were analyzed and compared respectively.Chest CT parameters(including whole lung LAA%,left lung LAA%,right lung LAA%),lung function and heart color ultrasound parameters were compared between the two groups.Then,the correlation between CT parameters and cardiopulmonary function parameters in the two groups was analyzed.Finally,clinical characteristics of non-smoking COPD patients were comprehensively analyzed.Results:1.Among the 102 patients in this study,there were 52 males and 2 females in the smoking group,and 34 males and 14 females in the non-smoking group;In the non-smoking group,environmental exposure risk [83% vs 37%,P=0.000],female ratio[29.2% vs 3.7%,P=0.000],BMI[(22.65±3.05)kg/m2 vs(21.53±2.07)kg/m2,P=0.032]and uric acid [349.65(264.95～421.97)mmol/L vs 312.50(278.10～348.31)mmol/L,P=0.018] were higher than those in smoking group.There were no significant differences in age,erythrocyte count,erythrocyte distribution width,mean erythrocyte volume,leukocyte count,hemoglobin,platelet,CRP,total bilirubin,ALT,AST,BNP,D2 polymers and fibrinogen between the two groups(P > 0.05).2.In terms of quantitative parameters of chest CT,LAA%[(32.75±9.52)% vs(37.77±12.47)%,P=0.034] of both lung and left lung,LAA%[(33.74±10.19)% vs(39.01±13.20)%,P=0.036] and right lung LAA%[(31.64±9.82)% vs(36.99±13.07)%,P=0.041] were lower than those in smoking group.In terms of lung function,FEV1[(1.51±0.44)L vs(1.33±0.41)L,P=0.033],FVC[(2.33±0.57)L vs(2.11±0.38)L,P=0.017],FEV1 /FVC[(67.58±14.86)% vs(60.44±14.99)%,P=0.018] were higher than those in smoking group;In terms of echocardiogram results,the LEVF[(57.60±4.56)% vs(55.41±5.80)%,P=0.035] in the non-smoking group was higher than that in the smoking group,and the RVD[(34.21±4.76)% vs(35.76±1.94)%,P=0.039] was lower than that in the smoking group.There were no significant differences in PEF,MEF50,LVD,LAD and RAD between the two groups(P > 0.05).3.Similar to smoking group,total LAA%,left LAA% and right LAA% in non-smoking group were negatively correlated with FEV1,FVC,FEV1 /FV and LEVF in cardiopulmonary function parameters(P < 0.05),while positively correlated with RVD(P < 0.05).There was no significant correlation with LVD,LAD,RAD,PEF,MEF50 and BF(P > 0.05).Conclusion:1.Compared with smoking COPD,non-smoking COPD patients had higher environmental exposure risk,female proportion,BMI and uric acid.2.Compared with smoking COPD,non-smoking COPD has less emphysema and better cardiopulmonary function.3.Same as smoking COPD patients,LAA% parameter of non-smoking COPD patients is correlated with lung function and heart function.With the increase of LAA%,the worse lung function,the lower left ejection fraction and the larger right ventricular diameter.