Changes in pulmonary function, inflammatory factors, and clinical symptoms after smoking cessation in COPD patients with varied HRCT phenotypes

doi:10.3969/j.issn.1004-583X.2024.07.007

Abstract

Abstract:

Objective This study aims to evaluate the advantages of smoking cessation in patients with chronic obstructive pulmonary disease (COPD) across various high-resolution CT (HRCT) phenotypes. Methods We included 272 COPD patients who were smokers and underwent HRCT examination at our hospital's Department of Respiratory and Critical Care Medicine between June 2021 and June 2022. Patients were categorized based on their willingness to quit smoking and their success in doing so, while continuing their basic COPD treatment. A total of 104 successful quitters were selected for this study. These 104 COPD patients were further classified into three types according to the classification of low attenuation areas (LAA) under HRCT and the thickness of the airway wall: Type A (33 cases), Type E (35 cases), and Type M (34 cases). We recorded their lung function indicators (forced expiratory volume in the first second [FEV1], FEV1/forced vital capacity [FVC]), expression levels of inflammatory factors (T helper 17 cells/regulatory T cells [Th17/Treg], tumor necrosis factor alpha [TNF-α]), arterial carbon dioxide pressure (PaCO₂), erythrocyte sedimentation rate (ESR), cough score, and number of acute exacerbations. Results ①Lung Function Indicators: Prior to smoking cessation, there was no statistically significant difference in FEV1 and FEV1/FVC among the three groups (P>0.05). Post-cessation, both the A and E groups exhibited higher FEV1 and FEV1/FVC compared to the M group, with a statistically significant difference (P<0.05). ②Cytokine Expression Levels: Prior to smoking cessation, there was no statistically significant difference in Th17/Treg and TNF-α among the three groups (P>0.05). Post-cessation, both the A and E groups demonstrated lower Th17/Treg and TNF-α levels compared to the M group, with a statistically significant difference (P<0.05). ③PaCO₂ and ESR: Prior to smoking cessation, there was no statistically significant difference in PaCO₂ and ESR among the three groups (P>0.05). Post-cessation, both the A and M groups had lower PaCO₂ levels compared to the E group; both the A and E groups had lower ESR levels compared to the M group, with a statistically significant difference (P<0.05). ④Number of Acute Exacerbations and Cough Score: Prior to smoking cessation, there was no statistically significant difference in the number of acute exacerbations and cough score among the three groups (P>0.05). Post-cessation, both the A and M groups experienced fewer acute exacerbations compared to the E group; both the A and E groups had higher cough scores compared to the M group, with a statistically significant difference (P<0.05). Conclusion There are variations in the number of acute exacerbations and therapeutic effects post-smoking cessation among COPD patients with different HRCT phenotypes. Specifically, patients with Type E and Type M exhibit a weaker improvement effect after quitting smoking. However, quitting smoking has a more pronounced improvement effect on the number of acute exacerbations, lung function, and inflammatory factors in patients with Type A.

Key words: pulmonary disease, chronic obstructive, smoking cessation, high-resolution CT, respiratory function tests, inflammatory factors

CLC Number:

R563.9

Liu Cuicui, Zhu Yafang, Lyu Wenjuan. Changes in pulmonary function, inflammatory factors, and clinical symptoms after smoking cessation in COPD patients with varied HRCT phenotypes[J]. Clinical Focus, 2024, 39(7): 625-629.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.07.007

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I7/625

Figures/Tables 4

Tab.1 FEV1 and FEV1/FVC among the three groups( x -±s)

组别	例数	FEV1(%)		FEV1/FVC(%)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	44.62±12.64	51.41±3.02^*	43.64±10.64	54.64±5.64^*
E型组	35	45.61±12.87	51.94±4.27^*	44.97±10.72	55.27±5.72^*
M型组	34	42.72±12.95	47.47±3.23	44.67±10.57	47.67±4.57
$F$ 值		0.376	8.279	0.215	9.315
P值		0.719	0.001	0.805	0.001

Tab.1 FEV1 and FEV1/FVC among the three groups( x -±s)

组别	例数	FEV1(%)		FEV1/FVC(%)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	44.62±12.64	51.41±3.02^*	43.64±10.64	54.64±5.64^*
E型组	35	45.61±12.87	51.94±4.27^*	44.97±10.72	55.27±5.72^*
M型组	34	42.72±12.95	47.47±3.23	44.67±10.57	47.67±4.57
$F$ 值		0.376	8.279	0.215	9.315
P值		0.719	0.001	0.805	0.001

Tab.2 Th17/Treg and TNF-α among the three groups( x -±s)

组别	例数	Th17/Treg(%)		TNF-α(ng/L)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	2.42±0.59	1.91±0.52^*	18.08±3.51	5.64±2.19^*
E型组	35	2.45±0.57	1.94±0.39^*	15.19±3.18	4.27±2.26^*
M型组	34	2.64±0.55	2.37±0.26	18.28±3.29	7.29±2.14
$F$ 值		1.176	7.552	0.315	8.315
P值		0.352	<0.001	0.715	<0.001

Tab.2 Th17/Treg and TNF-α among the three groups( x -±s)

组别	例数	Th17/Treg(%)		TNF-α(ng/L)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	2.42±0.59	1.91±0.52^*	18.08±3.51	5.64±2.19^*
E型组	35	2.45±0.57	1.94±0.39^*	15.19±3.18	4.27±2.26^*
M型组	34	2.64±0.55	2.37±0.26	18.28±3.29	7.29±2.14
$F$ 值		1.176	7.552	0.315	8.315
P值		0.352	<0.001	0.715	<0.001

Tab.3 PaCO2 and ESR among the three groups( x -±s)

组别	例数	PaCO₂(mmHg)		ESR(mm/1h)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	47.73±10.87	41.41±9.82^#	29.18±9.29	25.64±10.19^*
E型组	35	55.89±21.42	48.39±12.38	38.25±11.45	33.14±10.26^*
M型组	34	47.14±8.73	47.47±10.09^#	46.38±15.19	41.29±12.14
$F$ 值		1.284	5.143	3.284	6.315
P值		0.256	0.033	0.951	0.014

Tab.3 PaCO2 and ESR among the three groups( x -±s)

组别	例数	PaCO₂(mmHg)		ESR(mm/1h)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	47.73±10.87	41.41±9.82^#	29.18±9.29	25.64±10.19^*
E型组	35	55.89±21.42	48.39±12.38	38.25±11.45	33.14±10.26^*
M型组	34	47.14±8.73	47.47±10.09^#	46.38±15.19	41.29±12.14
$F$ 值		1.284	5.143	3.284	6.315
P值		0.256	0.033	0.951	0.014

Tab.4 Acute attack frequency and cough score among the three groups( x -±s)

组别	例数	急性发作次数(次)		咳嗽评分(分)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	3.73±1.17	1.49±1.23^#	2.28±0.53	1.04±0.39^*
E型组	35	3.24±1.22	3.35±1.32	2.19±0.58	1.87±0.46^*
M型组	34	3.42±1.42	2.45±1.39^#	2.18±0.59	1.09±0.84
$F$ 值		0.912	8.143	0.315	7.912
P值		0.352	<0.001	0.715	<0.001

Tab.4 Acute attack frequency and cough score among the three groups( x -±s)

组别	例数	急性发作次数(次)		咳嗽评分(分)
组别	例数	戒烟前	戒烟后	戒烟前	戒烟后
A型组	33	3.73±1.17	1.49±1.23^#	2.28±0.53	1.04±0.39^*
E型组	35	3.24±1.22	3.35±1.32	2.19±0.58	1.87±0.46^*
M型组	34	3.42±1.42	2.45±1.39^#	2.18±0.59	1.09±0.84
$F$ 值		0.912	8.143	0.315	7.912
P值		0.352	<0.001	0.715	<0.001

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