Brain Function Changes In Patients With Chronic Obstructive Pulmonary Disease Without Hypoxemia

Objective:The present study performed resting state-functional magnetic resonance imaging(rs-fMRI)examination in smoking chronic obstructive pulmonary disease(COPD)male patients without hypoxemia and in normal smoking control group,to obtain abnormal areas of brain function changes.Try to screen early and effective intervention for the overall management of COPD and provide strategies for patients physical and mental treatment and prognosis.Method:The 2017 GOLD guidelines were used as the diagnostic inclusion criteria.20 male COPD patients without hypoxemia in the southwestern China were enrolled as group A,and 20 age-gender matched healthy smokers were recruited as group B).Inclusion criteria:Group A:Pulmonary function test showed forced expiratory volume in 1 second(FEV1)/forced vital capacity(FVC)(FEV1/FVC,one second rate)<70%,and the diagnosis of COPD with symptoms were given by respiratory specialist,such as chronic cough,dyspnea,etc.Patients are with a smoking history of at least 10 cigarettes per day for more than 5 years and arterial oxygenation partial pressure of oxygen(Pa02)?60mmHg;Group B:Pulmonary function test suggestion:FEV1>80%predicted value,FEV1/FVC?70%,arterial blood gas test Pa02?60mmHg,smoking at least 10 cigarettes per day,for more than 5 years and no history of smoking cessation in the past 3 months.Exclusion criteria:female,left hand,magnetic resonance examination contraindications,history of respiratory diseases such as bronchial asthma,history of lung surgery,history of central nervous system disease,history of central nervous system drugs usage,history of diabetes,history of hypertension,history of mental disease,history of trauma,history of taking psychotropic substances,recent history of anesthesia,history of head trauma,history of alcohol or drug abuse.All patients with COPD do not change in the original stable management treatment.All the selected data and clinical indicators were collected,and pulmonary function and arterial blood gas analysis were performed once recruited.Finally,rs-fMRI was performed on all subjects.For the general clinical data of the selected subjects,SPSS 22.0(SPSS Inc.USA)software package was used for statistical analysis,and DPARSFA software was used for image analysis and statistical analysis.Results:Compared with group B,group A had significant differences in the following brain function areas:bilateral cerebellar foot 1 area,cerebellar 8 area,sacral gyrus,cerebellar foot 2 area,fusiform gyrus,sacral sinus,hippocampus,cerebellar 9 area,sputum Middle back bungee,cerebellum 7b area,hippocampus side,cerebellum 4,5 area,cerebellar vermis 8 area,left amygdala.We analyzed the brain function changes of group A with disease duration,smoking index,Pa02,and FEV1.We found that right olfactory cortex,right straight gyrus,and right iliac crest were positively correlated with the duration of disease.The right caudate nucleus was negatively correlated with the duration of disease;the left inferior temporal gyrus,left fusiform gyrus,and left cerebellum 8 were negatively correlated with FEV1;right iliac crest,right iliac crest,right iliac crest,right The fusiform gyrus was negatively correlated with Pa02;the upper apical region of the right side was negatively correlated with smoking index.Conclusion:COPD without hypoxemia have been verified exist brain function change;Changes in brain function of COPD patients without hypoxemia are related to duration of disease,arterial oxygen partial pressure,FEV1,smoking index;Early diagnosis of COPD and treatment,mind on arterial oxygen partial pressure,and prevention of further decline in lung function may be essential for brain function protection in patients with COPD.