Study on benefit difference of smoking cessation on COPD smokers with different high-resolution computed tomography phenotypes

LIU Cuicui; ZHU Yafang; YANG Dan

doi:10.3969/j.issn.1002-7386.2025.05.010

Abstract：Objective To explore the difference in smoking cessation benefits of patients with chronic obstructive pulmonary disease(COPD)with different high-resolution computed tomography(HRCT)phenotypes based on the improvement of clinical symptoms,lung function,cytokines and exercise tolerance,in order to provide reliable reference data for clinical evaluation of the prognosis of COPD and formulation of individualized treatment.Methods Clinical data of 96 COPD patients admitted to the Respiratory Department from June 2021 to June 2022 were collected retrospectively.All patients were examined by HRCT at the time of visit,and they were divided into type A,type E and type M according to the examination results.According to whether the patients were willing to quit smoking,they were assigned into smoking cessation group(n=30)and smoking group(n=68).The clinical symptoms(COPD Assessment Test[CAT],modified Medical Research Council[mMRC]),lung function(forced expiratory volume in the first second[FEV1],percent-of-predicted forced expiratory volume in the first second[FEV1％],ratio of forced expiratory volume in the first second to forced vital capacity[FEV 1/FVC]),cytokines(interleukin-6[IL-6],interleukin-8[IL-8]),and exercise tolerance(6-min walking test[6MWT])were compared between the smoking cessation group and the smoking group under different HRCT phenotypes.Results At the end of the follow-up,clinical symptoms indicated by the CAT score and mMRC score in the smoking cessation group were significantly lower than those of the smoking group,and the exercise tolerance assessed by the 6MWT was significantly higher(P＜0.05).The CAT score and mMRC score of type A COPD patients were significantly lower than those of type E and M COPD patients,and the 6MWT of type A COPD patients was significantly higher than that of type E and M COPD patients(P＜0.05).There were no significant differences in the CAT score,mRC score,and 6WMT between type E and M COPD patients(P＞0.05).In terms of lung function,FEV 1,FEV1％and FEV1/FVC in the smoking cessation group were significantly higher than those of the smoking group(P＜0.05).The highest FEV 1,FEV1％and FEV 1/FVC were detected in type A COPD patients,followed by type E and type M COPD patients(P＜0.05).In terms of cytokines,the levels of IL-6 and IL-8 in the smoking cessation group were significantly lower than those of the smoking group(P＜0.05).The lowest levels of IL-6 and IL-8 were detected in type A COPD patients,followed by type E and M COPD patients(P＜0.05).Conclusion After smoking cessation,type A COPD patients benefit most in the improvement of clinical symptoms,lung function,cytokines and exercise tolerance,followed by type E patients,and type M patients have the least benefits.It helps evaluate the prognosis of COPD patients clinically and develop accurate and personalized treatment plans.