| Object:The aim of this paper is to analyze the clinical characteristics of COPD patients with different BMI,such as the number of acute exacerbations,hospitalization time,inflammatory index,pulmonary function,arterial blood gas and COPD complications,in order to explore the relationship between BMI and COPD patients,understand the impact of BMI on the severity and prognosis of COPD,and provide a theoretical basis for clinical treatment.Methods:The author selected 119 COPD patients hospitalized in Department of Respiratory Medicine,Affiliated Hospital of Yan'an University from October 2017 to October 2018.The diagnostic criteria of COPD were referred to GOLD 2017.According to BMI,it was divided into three groups: low BMI group: BMI < 18.5 kg/m2(n=34),normal BMI group: BMI 18.5-23.9 kg/m2(n=52);high BMI group: BMI < 24 kg/m2(n=33).Data of all subjects were collected: sex,age,BMI,smoking history,COPD history,hypertension history,coronary heart disease history,sleep apnea hypopnea syndrome(OSHAS)history,the number of acute exacerbations in the past 1 year,hospitalization time;procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC),neutrophil absolute value(NEU#),the absolute value of basal cell count(LYM#);arterial blood gas and pulmonary function;according to the comprehensive grouping standard of COPD published in GOLD 2017,they were divided into four groups: A,B,C and D;the general data of low BMI,normal BMI and high BMI groups were compared respectively,and the acute exacerbation times and hospitalization time of COPD in the past 1 year were compared among different BMI groups;the inflammatory indexes,pulmonary function,blood gas analysis and different pulmonary function scores were compared among different BMI groups.Pearson test was used to analyze the correlation between BMI and pulmonary function index;Spearman was used to analyze the correlation between BMI and pulmonary function classification;the difference of COPD comprehensive grouping among different BMI groups was compared;and the COPD complications among different BMI groups were compared.Result:1.There was no difference in sex,age and COPD history among different BMI groups(P > 0.05).2.The number of acute exacerbations of COPD and hospitalization time was different among different BMI groups(P < 0.05).The number of acute exacerbations of COPD in low BMI group was higher than that in normal BMI group and high BMI group(P < 0.05).The length of hospitalization in low BMI group was longer than that in normal BMI group and high BMI group(P < 0.05).3.PCT,CRP,WBC and NEU# were different among different BMI groups(P < 0.05).PCT,CRP,NEU,WBC in low BMI group were higher than those in normal and high BMI group(P < 0.05).There was no difference in LYM# among the three groups(P > 0.05).4.FEV1%,FEV1/FVC and FEV1 in low BMI group were lower than those in normal BMI group and high BMI group(P < 0.05).PaCO2 in low BMI group was higher than that in normal BMI group and high BMI group(P < 0.05).PaO2 in low BMI group was lower than that in normal BMI group and high BMI group(P < 0.05).5.The severity of pulmonary function in different BMI groups was different(P < 0.05).The pulmonary function in low BMI group with grade 2 was lower than that in normal BMI group and high BMI group.The pulmonary function of low BMI group with grade IV was higher than that of normal BMI group and high BMI group(P < 0.05).6.The correlation test showed that BMI was positively correlated with FEV1%(r= 0.523,P < 0.05).BMI was positively correlated with FEV1(r = 0.642,P < 0.05).BMI was positively correlated with FEV1/FVC(r = 0.258,P < 0.05).BMI was negatively correlated with pulmonary function grade(r=-0.318,P < 0.05).7.The overall comparison of COPD comprehensive assessment groups among different BMI groups was different(?2=14.114,P < 0.05).The COPD comprehensive assessment group in low BMI group was higher than that in normal BMI group and high BMI group(P < 0.05);the COPD comprehensive assessment group in low BMI group was higher than that in normal BMI group and high BMI group(P < 0.05).8.The proportion of hypertension and OSHAS in different BMI groups was different(P < 0.05).13 patients with high BMI combined with hypertension(54.2%)and 5 patients with OSAHS(83.3%)were higher than those with low BMI and normal BMI(P < 0.05).There was no difference in the proportion of patients with coronary heart disease among the three groups(P > 0.05).Conclusion:1.COPD patients with low BMI have more acute exacerbations and longer hospitalization time.2.Inflammatory markers PCT,CRP,WBC and NEU # were higher in patients with low BMI.3.BMI was positively correlated with FEV1% and FEV1.4.BMI was negatively correlated with pulmonary function grade and was associated with the severity of COPD.5.Patients with high BMI were more likely to have hypertension and OSHAS. |
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