Correlation Research Between Acute Exacerbation Of Chronic Obstructive Pulmonary Disease And The Weight Change

Objective:Through the acute exacerbation of chronic obstructive pulmonary disease(AECOPD) in patients with clinical data were analyzed,observe the different body mass index(BMI) and clinical features of patients with AECOPD and its influence to the illness. Methods:This retrospective review of hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease in the traditional Chinese medical hospital of TianJin binhai new area tanggu from January 2014 to December 2014,a total of 82 patients were enrolled,included 60 male and 22 female patients,whose age was 51 to 88 years old,with an average age 73.76±10.07 years old.They were divided into two groups based on BMI:underweight group is A group(n=40),BMI￡21kg/m2;The normal weight group is B group(n=42),21 kg/m2<BMI<25kg/m2.All patients were analyzed records as follows : All of the patients medical history, physical examination, calculation of in-hospital time,antibiotics for a few days;Patients in the acute exacerbation within 1 year prior to admission number(in the hospital or the emergency observation through the number of times);Measure the height, weight;Determination of patients with peripheral blood leukocyte count and classification(N%), Serum calcitonin original, c-reactive protein(CRP) and erythrocyte sedimentation rate(ESR); Determination of fasting blood glucose(FBG), postprandial 2 hours blood glucose(P2hBG),fasting insulin(IRI) on an empty stomach,2 hours after a meal insulin(2h after meals IRI),glycated hemoglobin(HbA1c);Determination of blood cholesterol(CH),triglyceride(TG),serum albumin(ALB);Serum calcium,phosphorus,alkaline phosphatase(AKP);Arterial blood gas analysis: calculating oxygenation index(PaO2/FiO2);lung function indexes:predicted value of forced expiratory volume in the first one second(FEV1%),forced expiratory volume in one second-to-forced vital capacity ratio(FEV1/FVC),maximum minute ventilation(MVV),deep inspiratory capacity(IC),residual volume(RV) and total lung capacity(TLC) and other clinical data.Investigate patients of pulmonary function in the stability period prior to admission,according to the guidelines of diagnosis and treatment of chronic obstructive pulmonary disease(2013 revision) on pulmonary function classification,we compare each index of two groups of patients,and analysis of weight change on acute exacerbation of COPD patients. Result:A total of 82 cases of COPD patients into the study,including 40 patients with low body mass index(BMI),a lower body mass index of 42 cases,there are no significant difference in age,gender,history of chronic cough,history of smoking and complications of two groups(P>0.05);Different classification of lung function have no difference(P>0.05); BMI in both groups have significant difference(P<0.05). Compared with group B, group A lung function index FEV1%,FEV1/FVC%,MMV,IC were decreased,the RV/TLC is elevated,the statistical difference was significant(P<0.05);Two groups of patients oxygenation index(PaO2/FiO2) difference was statistically significant(P<0.05).A group of patients with longer antibiotics for a few days and hospitalization compared with group B,A group patients within 1 year of acute exacerbation frequency higher than group B,the statistical difference was significant(P<0.05).The blood ESR and PCT concentration of A group patients higher than that of group B patient,the statistical difference was significant(P<0.05);The blood CRP concentration,peripheral blood WBC count and classification of A group patients higher than that of group B patients,the statistical difference was significant(P<0.05).The blood calcium and blood phosphorus levels differences have no statistical significance in two groups of patients(P>0.05);A group of alkaline phosphatase levels higher than group B,the statistical difference was significant(P<0.05).Patients with two groups of FBG and P2 hBG,HbA1c,fasting IRI indicators have no statistical difference(P>0.05);A group of patients with postprandial 2 h IRI level higher than that of group B,the statistical difference was significant(P <0.05).Two groups of patients with blood cholesterol,triglycerides and blood albumin differences had no statistical significance(P>0.05). Conclusion: 一、The relationship between the body mass index and AECOPD1、In low body mass index(BMI) patients,1 year exacerbations frequency higher than patients with normal body mass index(BMI).2、Low body mass index(BMI) in patients with AECOPD,in the aspect of a antibiotics for a few days and hospitalization were significantly longer than patients with normal body mass index(BMI).3、No obvious difference was found between different body mass index of the incidence of complications. 二、The relationship between the body mass index and COPD lung function1、Lung function classification in stability patients with different body mass index has no obvious difference.2、In low body mass index(BMI) patients,airway obstruction and lung excessive air situation is more serious,the lack of oxygen and respiratory dysfunction occurred more often. 三、The relationship between the body mass index and AECOPD inflammation indexLow body mass index(BMI) patients with AECOPD, inflammation index increased more significantly than normal body mass index. 四、The relationship between the body mass index and metabolic indicators in AECOPD1、Low body mass index(BMI) patients with AECOPD,alkaline phosphatase activity increased.2、Low body mass index(BMI) patients with AECOPD,postprandial 2hIRI levels higher than normal body mass index in patients with AECOPD.3、No obvious difference was found between different body mass index of blood cholesterol,triglycerides and albumin.