Prospective Research On The Relations Between The Persistent Systematic Inflammation Of The COPD Patients And Anxiety And Depression

Objective: we investigate existence of Persistent Systematic Inflammation(PSI)among the COPD patients in local areas.In addition,we analyze the PSI impact on the grading of anxiety and depression.The results provide possible basis for curing these patients.Methods : This study is a prospective observation research.Based on the comparison of the COPD patients and the healthy control group,test results of the inflammation markers(IL-6,IL-8,and Activin A)in the candidates' blood samples,and acquired basic information of the candidates.Smoking is a significant factor in COPD patients,therefore,we define the value of the 95 th percentile of inflammation marker concentration that is greater than the concentration in non-smoking healthy samples as the threshold value,also known as normal ceiling limit value.Two or more values of inflammation markers in the COPD patients' blood sample exceed the threshold implies the existence of PSI.We categorize the COPD group into three classes,which respectively has none,one and two or more over-threshold values of inflammation markers.Based on a one-year follow up with these patients,we define the ones with two or more over-threshold values of inflammation markers as PSI,and the ones with zero over-threshold values of inflammation markers as NI.We conduct single factor analysis of these two groups,and then perform regression analysis after confounding factor adjustment.We conclude the risk factors of the PSI based on the data analysis.After that,we analyze the relations between PSI and anxiety and depression,based on the grading of anxiety and depression levels of the COPD patients,and the results of multi factor linear regression analysis on the anxiety and depression grades.Results: On the three time stamps of origin,half year and one year,there are 33 patients who have two or more over-threshold values of inflammation markers(PSI group),and there are 64 patients who have zero over-threshold values of inflammation markers(NI group).Single factor analysis of these two groups shows that the following factors have no effect on these two groups: age,gender,cardiovascular disease,education level and smoking.However,the PSI group has higher BMI value,higher CAT grade,higher SGRQ-C total score,lower expected FEV1% value,lower FDV/FVC value,more Acute exacerbation,more frequent uses of ICS medicines,and longer accumulated smoking time.These factors all have statistical significance(P<0.05).We use single factor analysis to exclude confounding factors,and then gather the single factors that have P<0.05 to perform logistic multi factor analysis.We look for dependent variables of PSI,and the analysis results show that BMI value,FEV1% value and SGRQ-C total score are independent risk factors leading to PSI.Among these factors,BMI value and SGRQ-C total score are in directly proportional to PSI risk level,FEV1% value is in inversely proportional to PSI risk level,and BMI value has the highest probable impact(OR=1.209).Using the anxiety and depression scale table(i.e.HADSA,HADSD)to count the grades of the COPD patients,we set HADSA and HADSD scores as dependent variables,and PSI and SGRQ-C total score as independent variables.Multi factor linear regression results show that HADSA and HADSD scores are irrelevant to PSI,and SGRQ-C score is in directly proportional to HADSA and HADSD scores.Conclusions:1.The COPD patients in the local areas may have PSI or NI.The incidence of PSI is 20%(n=33).2.For the PSI and NI groups in our research,the PSI group has higher BMI value,higher CAT grade,higher SGRQ-C total score,lower expected FEV1% value,lower FDV/FVC value,more acute exacerbation,more frequent uses of ICS medicines,and longer accumulated smoking time,and these differences all have statistical significance(P<0.05).The patients who have this inflammation condition may have a new COPD phenotype,which may become future goal of curing,for example,the pertinence anti-inflammatory cure.3,The risk factors that lead o BMI may be the higher BMI.Therefore,proper weight control may be a good intervention to the COPD patients.4,The existence of PSI is irrelevant to the anxiety and depression grading of the COPD patients.Living quality may have hire relevance to the anxiety and depression grading of the COPD patients.