Comparison Of Lung Function And Hemoglobin In Chronic Obstructive Pulmonary Disease Patients Bewteen Emphysema And Non-emphysema Subtypes

Objective: To explore the difference between emphysema and non-emphysema,the two subtypes of COPD, which were devided by visual assessment on computedtomography. In order to provide clinical characteristics for the treatment of emphysema.We compared the routine blood test, arterial blood gas analysis, pulmonary function,echocardiography, and other indicators of inflammation between the two subtypes ofCOPD.Methods: A total of75COPD patients were recruited from the respiratorydepartment of the second Affiliated Hospital of Dalian Medical University fromFebruary2013to March2014. The control group included27participants withoutCOPD. All subjects underwent CT and were recorded the height and weight. Accordingto emphysema or not on CT imaging, the75COPD patients were devided into twogroups,33cases of emphysema predominant (low attenuation area>50%lung field)and42cases non-emphysema (low attenuation area <25%lung field). We recordedperipheral blood hemoglobin of all the subjects, as well as height, body weight D-dimer,fibrinogen (Fbg), arterial blood gas analysis (PaO2, PaCO2), lung function (FEV1/FVC,FEV1%predicted values, RV/TLC) and echocardiography (right ventricular diameter,right ventricular outflow tract diameter). We compared the differences of BMI,FEV1/FVC, FEV1%predicted values and hemoglobin among the control group,emphysema and non-emphysema by using independent samples t test through SPSS17.0software. Pearson correlation analysis was used to analyze the correlation between BMI and FEV1/FVC in the emphysema.Results: The BMI of emphysema group [（23.03±3.48）kg/m2] was lower than theBMI of non-emphysema group （[24.88±3.42）kg/m2]（t=2.31，P＜0.05）,was also lowerthan the BMI of control group [（24.86±3.00）kg/m2]（t=-2.16，P＜0.05）. Thedifference was statistically significant; The hemoglobin of emphysema group [(145.12±15.02) g/L] was higher than the hemoglobin of non-emphysema group [(137.86±12.72) g/L]（t=-2.27，P＜0.05）,was also higher than the hemoglobin of controlgroup[（136.78±12.33）g/L]（t=2.32，P＜0.05）. The difference was statisticallysignificant; The FEV1/FVC of emphysema group （[51.18±11.22）%] was lower than theFEV1/FVC of non-emphysema group [（61.6±12.41）%]（t=3.76，P＜0.05）,was alsolower than the FEV1/FVC of control group [（78.81±5.34）%]（t=-12.52，P＜0.05）.The difference was statistically significant; the FEV1%predicted of emphysema group[（54.15±20.14）%] was lower than the FEV1%predicted of non-emphysema group[（66.33±19.40）%]（t=2.66，P＜0.05）,was also lower than the FEV1%predicted ofcontrol group [（99.15±14.22）%]（t=-10.12，P＜0.05）. The difference was statisticallysignificant;In the emphysema group, the FEV1/FVC and BMI (r=0.437, P=0.011)were positively correlated. However, there was no difference in the D-dimer, fibrinogen(Fbg), arterial blood gas analysis (PaO2, PaCO2), echocardiography (right ventriculardiameter, right ventricular outflow tract diameter) between the emphysema andnon-emphysema groups（P＞0.05）.Conclusion: The nutritional status of the emphysema patients was poorer thannon-emphysema group in COPD patients and was associated to the pulmonary functionwhich was damaged obviously in the emphysema patients. Hemoglobin in theemphysema group was increased by chronic hypoxia.