Study On The Clinical Features Of Chronic Obstructive Pulmonary Disease With Chronic Bronchitis

Objective:To analyze the clinical characteristics of chronic obstructive pulmonary disease-chronic bronchitis phenotype?referred to as CB phenotype??general information,quality of life score?CAT,mMRC?,radiological characteristics,treatment plans and risk factors of acute exacerbation?so as to provide some clinical guidance for improving the quality of life,reducing acute exacerbation and delaying the development of the disease in COPD patients with CB phenotype.Methods:The clinical data of patients with acute exacerbation of chronic obstructive pulmonary disease?AECOPD?who were admitted to the Department of Respiratory Medicine in our hospital from January 2018 to December 2019 were collected,and all patients were divided into CB or non-CB phenotype group according to the established classification criteria.The differences in general information,quality of life scores?CAT,mMRC?,laboratory indicators,radiological characteristics,and treatment plans were compared between the two groups.Results:A total of 209 COPD patients with acute exacerbation of COPD who met the inclusion and exclusion criteria were collected.Among them,122 patients classified as CB phenotype,another 87 patients as non-CB phenotype.Compared with the non-CB phenotype,patients with CB phenotype were older?74.39±7.85 years vs 71.56±7.67years,P=0.011?,had more acute exacerbations?1.66±0.67 times vs 1.41±0.56 times,P=0.008?,longer duration of disease?18.48±14.68 years vs 13.40±10.75 years,P=0.029?,higher smoking index?45.22±31.59 year package vs 35.62±27.12 year package,P=0.024?,increaed quality of life scores[CAT?26.63±5.01 vs 23.75±6.33,P=0.001?,mMRC?2.75±0.84 vs 2.36±0.98,P=0.006?],and higher proportion of cough with abundance of phlegm?81.15%vs 66.67%,P=0.017?;higher levels of EOS count?194.30±202.52/?l vs 139.30±148.58/?l,P=0.020?,ratios of EOS?100/?l?67.21%vs52.87%,P=0.036?,C-reactive protein?28.51±17.24 mg/L vs 25.05±21.54 mg/L,P=0.024?,ESR?10.75±5.82 mm/h vs 9.01±4.08 mm/h,P=0.006?,and higher proportion of airway wall area?WA%??76.20±4.13%vs 73.16±3.34%,P=0.037?,bronchial wall thickening scores?1.37±0.55 vs 1.15±0.36,P=0.001?;yet lower FEV₁%pre?46.57±13.26%vs 54.01±14.90%,P=0.000?,FEV₁/FVC%?53.67±13.16%vs59.54±10.05%,P=0.001?and lung emphysema scores?1.84±0.94 vs 2.62±1.07,P=0.000?.Multivariate regression analysis showed that age?OR:1.044,P=0.046?,number of exacerbations?OR:1.901,P=0.013?and duration of disease?OR:1.026,P=0.042?were the independent risk factors for acute exacerbations of COPD subjects presenting with CB phenotype,which were positively correlated with acute exacerbation.In contrast,FEV₁%pre?OR:0.967,P=0.004?,FEV₁/FVC%?OR:0.967,P=0.029?as the independent risk factors were negatively correlated with acute exacerbation in those patients.There were no significant difference in other clinical data and laboratory indicators?P>0.05?.Conclusions:Clinical characteristics in acute exacerbation of COPD subjects with different phenotypes had specific.Clarifying the clinical,physiological,and radiological characteristics can be used to provide clinical guidance for improving the quality of life,reducing acute exacerbation and delaying the development of the disease in patients with CB phenotype.