Comparative analysis of clinical characteristics of frequent acute exacerbation phenotype and non-frequent acute exacerbation phenotype in chronic obstructive pulmonary disease

Zheng Qi; Qin Binbin; Shen Bin; Huang Yingjun; Zhu Jiayan; Hu Jingwei; Zheng Xingdong; Song Yajun

doi:10.3760/j.issn.1673-4777.2024.03.008

Abstract：Objective To compare the clinical characteristics of frequent acute exacerbation phenotype and non-frequent acute exacerbation phenotype in chronic obstructive pulmonary disease(COPD).Methods Sixty COPD patients who were hospitalized in the outpatient,emergency and respiratory departments of Huangpu Branch,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from October 2019 to May 2022 were selected as the research objects.According to the annual frequency of acute exacerbations,the patients were divided into non-frequent acute exacerbation phenotype group(30 cases with 0-1 annual exacerbations)and frequent acute exacerbation phenotype group(30 cases with ≥ 2 annual exacerbations).The neutrophil to lymphocyte ratio(NLR)and levels of C-reactive protein(CRP),procalcitonin,interleukin-6(IL-6),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),and forced expiratory volume in one second as percentage of predicted volume(FEV1％)were tested and calculated in two groups based on venous blood extracted on the day of visit.The scores of COPD self-assessment questionnaire test(CAT)score and modified version of the British Medical Research Council respiratory questionnaire(mMRC)score were evaluated and compared between groups.The correlation between the related indicators and the severity of the disease was analyzed.Results The NLR,CRP,procalcitonin,IL-6,PaCO2 levels,CAT and mMRC scores of patients in the frequent acute exacerbation phenotype group were higher than those in the non-frequent acute exacerbation phenotype group;PaO2 and FEV1％ were lower than those in the non-frequent acute exacerbation phenotype group[(9.6± 1.1)kPa vs(10.8±2.5)kPa,(44±9)％ vs(57±5)％](all P＜0.05).The levels of NLR,CRP,procalcitonin,IL-6,and PaCO2 in COPD patients were positively correlated with the annual number of acute exacerbations,PaO2 and FEV1％ were negatively correlated with the annual number of acute exacerbations(all P＜0.05).Conclusion Patients with frequent acute exacerbations phenotype of COPD have higher levels of pulmonary inflammation,poorer lung function and more severe symptoms.Early intervention should be given to improve the prognosis of patients.