THE CORRELATION BETWEEN DIFFERENT HRCT PHENOTYPES AND SMOKING INDEX AND GOLD GRADUATION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

QIAN HE#, SHI-ZHEN HE#, YUN-SHAN SU, PENG WANG, SHU-TIANG XIANG*, WEI SU, CHONG-WEN MAO

Department of Radiology, the second people’s hospital of Yunnan province, the fourth affiliated hospital, Kunming Medical University, Kunming, Yunnan, 650000, P.R.China

Objective: This study aims to investigate the smoking index and lung function changes of chronic obstructive pulmonary dis- ease (COPD) patients with different HRCT manifestations.

Methods: A retrospective analysis was conducted on the pulmonary function of 56 patients. These patients were divided into three groups: phenotype A (Airway type), phenotype E (Emphysema type), and phenotype M (Mix type). Pulmonary function test (PFT) and high-resolution computed tomography (HRCT) were performed within three days. The imaging classification of patients was based on emphysema and bronchiectasis, which was assessed on HRCT images. Furthermore, the clinical characteristics and Global Initiative for Chronic Obstructive Lung Disease (GOLD) graduation among the different phenotypes were analyzed.

Results: The smoking index of phenotype A, phenotype E and phenotype M was 359.47 ± 114.24, 468.00 ± 119.42 and 400.7 ± 136.87, respectively, and the difference in smoking index among these three phenotypes was statistically significant (P<0.001). In phenotype A, the GOLD grade was mild in five patients, moderate in 21 patients, severe in four patients, and critically severe in one patient. In phenotype E, the GOLD grade was mild in one patient, moderate in two patients, severe in six patients, and critically severe in two cases. In phenotype M, GOLD grade was mild in one patient, moderate in three patients, severe in eight patients and critically severe in two patients. The difference in GOLD grades among these different phenotypes was statistically significant (P=0.006).

Conclusion: Smoking is one of the risk factors that lead to emphysema. Patients with phenotype M had emphysema and bronchial wall thickening at the same time. Furthermore, these patients had the most severe airflow limitation, severe and critically severe GOLD grades, and the most obvious lung function damage in the middle and late stages of the disease.