| Objective:Chronic obstructive pulmonary disease(COPD) is a disease characterized by inconvertible current limitation,it affect the pulmonary function and life quality in COPD patients which results in economy burden to the society and family. Smoking is the main risk factor of COPD and smoking cessation can not only prevent COPD,but also alleviate the aggravation.The research is to analyse the relationship between smoking cessation under physician persuasion and lung function with life quality in COPD patients by detecting the density of exhaled CO, pulmonary function, peak expiratory flow, clinical symptom scores and COPD assesment test scores,so it can provide theory basement to clinical practice in COPD and then increase the awareness of smoking cessation and prevent the aggravated condition of COPD patients.Methods:1. Grouping:Collect 233 male COPD patients treated in the pneumology department of Affiliated Hospital of ChengDe Medical College from December 2008 to September 2011.Of which there were 20 patients who never smoked(non-smoking group),54 patients who had stopped smoking for more than 2 years(ex-smoking group).Divide the others into smoking cessation group(92) and smoking group(67) by whether the smokers did through physician smoking cessation advice.2. Procedures:Introduce the process of the research to the subjects above to acquire comprehension.Redetect exhaled CO density,pulmonary function, peak expiratory flow and clinical symptom scores in the 3rd,6th,9th and 12th month after detecting the original indexes above, summarize the exacerbation frequencies and CAT scores after 12 months. Then compare the indexes above among the groups in the year.3. Statistical analysis:SPSS version 11.5 was used for the computer, the data was expressed by x ± S, the sample constitution in each group was compared using chi-square test, the density of exhaled CO and pulmonary function indexes among the four groups was compared using repeated measurement two factor multilevel analysis of variance, mutual comparison of the density of exhaled CO,pulmonary function indexes and CAT scores among the four groups in the same time using multivariate analysis of variance. Acute exacerbation frequencies were compared using Kruskal-Wallis H, there is statistical significance if P value is lower than 0.05.Results:1. The comparison of density of exhaled CO and COHb% among the four groups:As metabolites of cigarette,the higher the density of exhaled CO,the greater the amount of smoking.Initially the density of exhaled CO in smoking cessation and smoking group was higher than ex-smoking and non-smoking group.However, it is higher in smoking group when in the 3rd,6th,9th,12th month,there is statistical significance in the difference(P<0.05);The density of exhaled CO in smoking cessation group was significantly lower 3 months after smoking cessation.The change in the concentration of carboxyhemoglobin (COHb%) was coincidence with the density of exhaled CO.2. The comparison of pulmonary function indexes among the four groups: Pulmonary function is an objective index to judge airflow limitation in COPD patients,the greater the degree of its value is below normal,the more serious the airway obstructs. Indexes of the research includes SVC,IC,FVC, FEV1% pred,FEV1/FVC and lungage. There was not significantly difference in changes of the indexes above among the four groups at each time(P>0.05).In the year,SVC,IC,FVC,FEV1% pred and FEV1/FVC showed upward trends in smoking cessation group and downward trends in smoking group;In the 12th month, SVC,IC,FVC and FEV1% pred were significantly higer than the original in smoking cessation group and were significantly lower than the original in smoking group(P<0.05). The indexes above showed downward trends in ex-smoking and non-smoking group which was less than smoking group,and there were not significantly difference(P>0.05).In the year, lungage showed a downward trend in smoking cessation group and upward trends in smoking group. In the 12th month,the lungage was significantly lower than the original in smoking cessation group and was significantly higher than the original in smoking group(P<0.05).The lungage showed an upward trend in ex-smoking and non-smoking group which was less than smoking group, and there was not significantly difference(P>0.05).3. The comparison of PEF among the four groups:As an index to reflect the degree of airflow limitation, the greater the degree of PEF is below normal,the more serious the airway obstructs. There was not significantly difference in changes of PEF among the four groups at each time(P>0.05).In the year,PEF showed upward trend in smoking cessation group and downward trend in smoking group. In the 12th month, PEF was significantly lower than the original in smoking group(P<0.05);Compared with the original, PEF showed a downward trend in ex-smoking and non-smoking group, but there was not significantly difference(P>0.05).4. The comparison of life quality among the four groups:In this study, the life quality indexes were:clinical symptom score, exacerbation frequency, CAT score. Initially, there were not significantly difference in clinical symptom scores among the four groups(P>0.05).In the 12th month,clinical symptom scores in smoking cessation group were significantly lower than the original, and the scores in smoking cessation group were significantly lower than smoking group(P<0.05).Exacerbation frequencies in smoking cessation group were lower than smoking group(P<0.05).In the year,CAT scores in smoking cessation group were lower than smoking group(P<0.05).And in CAT,Question2 is about "sputum",the score of Question2 was higher in smoking group than the others(P<0.05).Conclusions:1. The exhaled CO density and COHb% in smoking cessation group were significantly lower than that in smoking group 3 months after smoking cessation,and nearly arriving the level in ex-smoking and non-smoking group,it showed that exhaled CO density and COHb% in COPD patients would return to normal 3 months after smoking cessation.2. Pulmonary function indexes such as SVC,IC,FVC and FEV1% pred in smoking cessation group were significantly higher than the original and lungage was significantly lower than the original 12 months after smoking cessation.Contrastly, pulmonary function indexes above were significantly lower than original and lungage was significantly higher than original in the 12th month, it showed that smoking cessation could alleviate pulmonary function aggravation then delay the growing of lungage.3. There was not significantly change in PEF in smoking cessation group compared with the original 12 months after smoking cessation.However,PEF was significantly lower than the original in the 12th month in smoking group, it showed that smoking cessation could delay the deterioration of PEF in COPD patients.4. The clinical symptom scores and exacerbation frequencies in smoking cessation group were significantly lower than smoking group, and nearly arriving the level of ex-smoking and non-smoking group, it showed that smoking cessation could delay the aggravation of COPD.5. CAT scores in smoking cessation group were significantly lower than smoking group, and nearly arriving the level of ex-smoking and non-smoking group, it showed that smoking cessation could improve the life quality of COPD patients.6. Smoking cessation can accelerates the clinical rehabilitation of COPD patients by alleviating pulmonary function aggravation, delaying the deterioration of PEF,alleviating the clinical symptoms, reducing exacerbation frequencies and improving the life quality of COPD patients... |
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