Analysis Of The Inflammation Index In COPD Patients With Or Without-bronchiectasis

Objective: Chronic Obstructive Pulmonary Disease(COPD) is a common persistent airflow limitation as to the characteristics of preventable and treatable disease, progressive development of airflow limitation, and airway and lung toxic particles or noxious stimuli enhanced chronic inflammation. Different pathological changes between different patients, resulting in clinical disease showed heterogeneity and different phenotypes. Along with high resolution computerized tomography(HRCT) widely used in clinic, people gradually recognize that there is two different computerized tomography(CT) phenotypes. COPD with bronchiectasis is widely recognized by the world since the 2014 guideline published. But there are many questions. In this study, the purpose is to compare the inflammation in COPD with or without bronchiectasis and to give some suggestions for clinical work.Methods: 1 This is a retrospective observational study conducted in the First Hospital of Shijiazhuang city,Hebei Province. One hundred and thirty two cases hospitalized in the hospital from January 2012 to January 2015 were enrolled into this study. The average age of the participants included in the analytic cohort was(67.40±7.56) years old. The patients’ data, including age, gender, laboratory data, such as lung HRCT examination and the clinical data were recorded and registered.According to 2013 Chinese MedicalBreathing Branch of COPD group, patients were then divided into two groups :COPD with bronchiectasis(group A) and COPD without bronchiectasis(group B), which was based on the clinical diagnosis and the CT examination.The clinical data, includingage, gender, laboratory data, the clinical character, lung HRCT,C-reactive protein(CRP), procalcitonin(PCT), and so on, were always recorded and registered. The patients conforming to the 2013 Chinese Medical Breathing Branch of COPD would enroll into the study. Patients would be excluded who suffered diabetes mellitus, systemic lupus erythematosus, immune thrombocytopenic purpura, rheumatoid arthritis, interstitial lung disease, primary bronchopulmonary carcinoma, heart failure, coronary heart disease, and so on. Then, all the patients were compared the inflammationindexes :1 The inflammation indexes were compared in group A with group B.2 The inflammation indexes in smoking and non-smoking groups were compared in group A.3 The smoking indexes were related with the inflammation indexes in group A. 4 Coughing purulent sputum in group A was compared with that in group B. 2 GroupsAccording HRCT, all the patients were divided into two groups. Chronic obstructive pulmonary disease(group A)and bronchiectasis(group B). There were 47 patients in group A, man36 and female 11. While there were 47 patients in group B, man 61 and female 24. Two experienced radiological department doctors seperatly detected. 3 Research method3.1ELISA assay serum PCT level.3.2 Analysis the general features of the study population in group A and group B. 3.3 Compare the WBC,CRP,PCT and percentage of N% in group A and group B. 3.4 Compare the WBC,CRP,PCT and percentage of N% in smoking and non-smoking groups. 3.5 Analysis the correlation between WBC、N%、CRP、PCT and smoking index in group A. 4 Statistical analyses Data analysis was performed by using the SPSS software program version 17.0(SPSS Inc., Chicago, IL, USA). Continuous variables with normal distribution were expressed as mean ± standard deviation and were compared by using Student’s t-tests. Variables with non-normal distribution were compared by the χ2 test. The degree of relationship was assessed by linear correlation. A value of P<0.05 was considered statistically significant.Results:1 There were no differences in age, oxygen partial pressure(PO2) and partial pressure of carbon dioxide(PCO2) between COPD with bronchitectasis and those in COPD without bronchitectasis(P>0.05).Body mass index(BMI) in COPD without bronchitectasis group was significantly higher than that in COPD with bronchitectasis group(P<0.05).2 As for leukocyte(White Blood Cell,WBC),the percentage of neutrophils(N%),PCT and CRP, the peak distribution was higher in group A than that in group B(P<0.05).3 Correlation analysis showed that there was no significant difference between smoking index and N percentage(r=0.135, P=0.445),CRP(r=0.03, P =0.0867), PCT(r=0.242, P=0.167), respectively, in group A. However, the positive correlation was observed between smoking index and WBC in group A(r= 0.378, P=0.028).4 The inflammation indexes in smoking were significantly higher than those in non-smoking of group A(P<0.05).5 Most of coughing purulent sputum in group A were higher than those in group B(P<0.05). There was significant difference between group A and group B.Conclusions:The levels of WBC,CRP, PCT,and N% in COPD with bronchiectasis are significantly higher than those in COPD without bronchiectasis.Smoking could aggravate the COPD with bronchiectasis.It was essential to recognize these.