Clinical Characteristics And Etiological Analysis Of Combined Pulmonary Fibrosis And Emphysema

Objective:We retrospectively analyzed the basic information,laboratory examination results,and imaging changes of patients with pulmonary fibrosis combined with emphysema syndrome(CPFE)admitted to the Second Hospital of Jilin University.We summarized and analyzed the clinical characteristics of CPFE to improve clinical doctors’ recognition of this disease and reduce misdiagnosis and missed diagnosis.Assist clinical doctors in identifying diseases and taking effective intervention measures to enhance their understanding of the disease.Methods:After strict inclusion and exclusion criteria,54 patients in the CPFE group and 60 patients in the Idiopathic Pulmonary Fibrosis(IPF)group were determined for inpatients with interstitial lung disease admitted to the Second Hospital of Jilin University from January 2017 to December 2021.The data collected from the enrolled patients included gender,age,body mass index(BMI),length of stay,smoking history,smoking index,clinical symptoms(cough,expectoration,dyspnea),signs(Velcro rale),white blood cell count,neutrophil percentage,lymphocyte percentage,red blood cell distribution width,D-dimer,erythrocyte sedimentation rate,hypersensitive C-reactive protein,tumor markers,arterial blood gas analysis,Lung function and high-resolution computed tomography(HRCT)of the chest.Analyze whether there is a correlation between the distribution width of red blood cells and the severity of CPFE,and explore the diagnostic or predictive value of red blood cell distribution width in CPFE.Use statistical analysis software SPSS 26.0 to analyze the collected data of two groups of patients and obtain the results.Results:1.The patients in the two groups are mainly male,and the age distribution is mostly middle-aged and elderly.The age of patients in the CPFE group is 66.56±7.32 years old,and the age of patients in the IPF group is 64.57±8.87 years old.In the CPFE group,37 patients had a history of smoking,while in the IPF group,24 patients had a significant difference(P<0.05).The smoking index of patients in the CPFE group was as high as 400(0,800)cigarettes per year,while the smoking index of patients in the IPF group was 0(0,450)cigarettes per year.The difference is statistically significant(P<0.05).2.In patients with CPFE,the red cell volume distribution width(RDW)was higher than in patients with IPF,with the former being 13.00(12.50,13.90)% and the latter 12.45(11.90,13.28)%,with a statistically significant difference(P<0.05).3.The CPFE group and IPF group patients were both in a state of no oxygen inhalation.The results of Pa O2 were compared in blood gas analysis between the two groups.The CPFE group patients had a decrease of 73.00(67.00,80.00)mm Hg compared to the IPF group patients with a decrease of 78.00(70.00,82.75)mm Hg,with a statistically significant difference(P<0.05).4.The analysis of lung function results between patients in the CPFE group and those in the IPF group showed that the DLCO% and FEV1/FVC% values in the CPEF group were 39.65(28.93,53.78)% and 74.52 ± 9.70%,respectively,while those in the IPF group were 53.65 % and 80.59 ± 6.87%.The results in the CPFE group were even worse,with a statistically significant difference(P<0.05).The proportion of obstructive ventilation dysfunction in the CPFE group was 27.78%,which was higher than that in the IPF group,which was 6.67%.5.HRCT of lung in CPFE group showed that paraseptal emphysema was the most common type,followed by centrilobular emphysema.6.The serum RDW of patients in CPFE group was negatively correlated with the levels of FVC% pred,FEV1,FEV1% pred,FEV1/FVC%,VCmax,VCmaxpred,DLCO% in lung function(P<0.05).7.The AUC value of serum RDW in the CPFE group was greater than 0.5,the 95%confidence interval was 0.565-0.764,P<0,05,the critical value was 12.45U/ml,the sensitivity was 79.6%,and the specificity was 50.0%.Conclusions:1.The patients with CPFE are mainly middle-aged and elderly men,who have a history of long-term and severe smoking.Smoking is the pathogenic factor of CPFE,and patients should strengthen smoking cessation.2.The degree of hypoxia in CPFE patients is more serious than that in IPF alone,and the condition of airflow restriction and diffusion function in lung function are worse than that in IPF alone.3.The serum RDW in the CPFE group is negatively correlated with lung diffusion function,and serum RDW has certain clinical value in diagnosing and evaluating the severity of CPFE.