Clinical characteristics of the emphysema phenotype of chronic obstructive pulmonary disease at acute exacerbations

Abstract

Objective To study whether there were clinical characteristics associated with the emphysema phenotype of chronic obstructive pulmonary disease (COPD). Methods We reviewed the clinical data of 95 patients who were admitted to Department of Respiratory Medicine, Beijing Tongren Hospital ,Capital Medical University, for severe exacerbation of COPD from April, 2009 to June, 2010.The patients, 60 were male and 35 were female, aged from 41 to 92 years old,average age (75±9) years old. Based on HRCT visual assessment of emphysema, the patients were classified into 2 groups: mild emphysema group (score≤8) and severe emphysema group (score＞8). Statistical analysis between these two groups regarding demographic and physical characteristics, such as gender, age, BMI, smoking index, comorbidities, lung function, ultrasonic cardiogram, blood routine, artery blood gas analysis,systemic inflammation marker (CRP, FIB, etc. ) was permormed. Results Among 95 subjects, 40 patients (26 were male and 14 were female) were in mild group and 55 patients(34 were male and 21 were female) in severe group. The average score and mean age in mild group were respectively (4. 54 ±2. 08)scores and (72. 98 ± 10. 98) years, and in severe group were respectively (17.67 ± 6.31) scores and (76. 48±7. 60) years. There was no statistical difference in gender between two groups. The mean age of patients in severe groups was much higher than mild group ( P＜0. 05). Significant differences can be seen between two groups with respects to BMI, smoking index, prevalence of cardiovascular disease,PCO2, FEV1/FVC, incidence of pulmonary hypertension, FIB and CRP level in plasma. These variances in severe emphysema group were higher than mild group. No significant difference was found in PO2,prevalence of anemia and FEV1 % pred between the two groups. Conclusions The emphysema phenotype of COPD is associated with some markers which can reflect the systemic inflammation and severity of the disease at acute exacerbations. Key words: Chronic obstructive pulmonary disease; Tomography; X-ray computed; Visual assessment of emphysema; Phenotype