| Objective:To analyse the effectiveness of the air pollution on clinical symptoms, acute exacerbation risk and severity of grouping of patients with chronic obstructive pulmonary disease(COPD) in the northern region (Represented by Beijing and hebei)and analyse the effect of environmental factors on the differential expression of microRNAs in peripheral blood of migratory patients in northern and local patients in northern.Methods:1. (1)118 patients with COPD were enrolled in the prospective study from October 2014 to April 2015. (2)We collected the general information of patients with COPD. (3)The standard that as the assessment of air pollution is the ambient air quality index (AQI).When the air quality is superior,AQI is less than or equal to 100 and when the air is polluted,AQI is more than 100. (4)We analyzed differences in CAT, mMRC effected of the air pollution(as indicators for the entry).(5)After one year of follow-up, we analyzed differences in CAT, mMRC effected of the air pollution. (6)We analyzed differences between the follow-up CAT score, the follow-up mMRC, the number of exacerbations in the previous year of follow-up and the CAT score of the entry, the mMRC of the entry, the number of exacerbations over the past year before the entry.2. (1) Patients with COPD were divided into A,B,C,D group according to guidelines of GOLD 2014. There were 26 cases of group A,20 cases of group B,22 cases of group C,50 cases of group D. (2)We analyzed differences in CAT, mMRC effected of the air pollution of four groups and we analyse the number of exacerbations Over the past year of four groups. (3)After one year of follow-up, we analyzed differences in CAT, mMRC effected of the air pollution and the number of exacerbations Over the past year of four groups.3. (1)Blood samples were collected from 9 patients with COPD in Beijing group,8 paitents of migratory and 9 healthy control subjects. (2)After extracting total RNA from the three groups,serum miRNAs were identified by solexa sequencing.Results:1. (1)These COPD patients included 91males and 27 females, with a median age of 63.00 (56.75-73),a median FEV1/FVC of 51.46 (41.39-59.49) and a median Predicted FEV1 of 53.75 (38.225-68.60). Smokers accounted for 65.25. (2) When AQI>100, the CAT score of the baseline and the mMRC of the entry were significantly higher than that of AQI<100 (P<0.001). (3)When AQI>100, the follow-up CAT score and the follow-up mMRC were significantly lower than that of AQI<100 (P < 0.001).(4)The follow-up mMRC were significantly higher than the mMRC of the entry(P=0.04).But the difference in CAT between the entry and the follow-up was not statistically significant.(5)The difference in the number of exacerbations between before the entry and the follow-up was not statistically significant.2. (1) According to the guidelines of GOLD 2014, the AC group was the group with fewer symptoms, and the BD group was the group with multiple symptoms, the AB group was the low risk group, and the CD group was the high risk group. (2)When AQI<100, the CAT score of the entry of the fewer symptoms group were 6.50 (4.00-8.75). But when AQI>100, the CAT score of the entry of the fewer symptoms group were10.00 (6.25-12.00).The median of the CAT score closed to 10 and the clinical symptoms increased affected by air pollution. The fewer symptoms group changed into the multiple symptoms group. But the mMRC did not cross.(2)When AQI≤100, the CAT score of the follow-up of the fewer symptoms group were 8.00 (4.25-12.00) But when AQI>100, the CAT score of tthe follow-up of the fewer symptoms group were 9.50 (6.00-16.75).The median of the CAT score closed to 10 and the clinical symptoms increased affected by air pollution. The fewer symptoms group changed into the multiple symptoms group. But the result of mMRC did not indicate the change. (3)The difference in the number of exacerbations of the the low risk group between before the entry and the follow-up was not statistically significant. The low risk group did not change into the high risk group.3. Three groups of samples were qualified and 9 miRNAs might be differentially expressed after solexa sequencing and screening.Conclusion:1.The CAT score and the mMRC of the patients with chronic obstructive pulmonary disease in the northern area increase affected of air pollution.2.The fewer symptoms group change into the multiple symptoms group affected of air pollution.But the effect of air pollution on the risk of acute exacerbation is not found after follow-up.3.Environmental factors may cause the difference of miRNAs expression in peripheral blood of migratory patients in northern and local patients in northern. |
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