Yang Zhenjiao, Cui Miaoling, Zhang Jianquan, Wang Zixiu, Yao Guirui, Fu Xia
Department of Respiratory and Critical Care Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, People's Republic of China.
Department of Nursing, The First Hospital Affiliated to Guangxi Medical University, Nanning, Guangxi, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 Jul 22;20:2569-2579. doi: 10.2147/COPD.S511879. eCollection 2025.
Patients with chronic obstructive pulmonary disease (COPD) exhibit various patterns of co-occurring complex symptoms. However, identifying core symptoms based on these distinct symptom patterns remains limited.
The aims of this current study were to explore symptom subgroups among patients with COPD based on their unique symptom experiences and to identify the core symptoms within these subgroups, along with the correlation of these core symptoms with laboratory indicators.
From May 2018 to December 2023, we recruited 252 participants with COPD through a convenience sample in China. Participants were investigated using the Revised Memorial Symptom Assessment Scale (RMSAS). Latent profile analysis (LPA) was conducted to identify symptom subgroups, while network analysis was used to reveal core symptoms among subgroups identified by LPA.
Based on symptom experiences, two subgroups of patients were identified: the "low" symptom burden subgroup and the "high" symptom burden subgroup. In both the total sample and the low symptom burden subgroup, "feeling sad" was identified as the core symptom, whereas "feeling drowsy" was the core symptom in the high symptom burden subgroup. The neutrophil-to-lymphocyte ratio was associated with the severity of drowsiness.
This study highlights the heterogeneity among COPD patients with multiple symptoms, resulting in the identification of two distinct symptom subgroups. Addressing symptoms of sadness and drowsiness may serve as a crucial target for alleviating the overall symptom burden in individuals with COPD.
慢性阻塞性肺疾病（COPD）患者表现出多种并发的复杂症状模式。然而，基于这些不同症状模式识别核心症状仍然有限。
本研究的目的是根据COPD患者独特的症状体验探索症状亚组，识别这些亚组中的核心症状，以及这些核心症状与实验室指标的相关性。
2018年5月至2023年12月，我们在中国通过便利抽样招募了252名COPD参与者。使用修订的纪念症状评估量表（RMSAS）对参与者进行调查。进行潜在剖面分析（LPA）以识别症状亚组，同时使用网络分析揭示LPA识别的亚组中的核心症状。
根据症状体验，识别出两组患者：“低”症状负担亚组和“高”症状负担亚组。在总样本和低症状负担亚组中，“感到悲伤”被确定为核心症状，而“感到困倦”是高症状负担亚组中的核心症状。中性粒细胞与淋巴细胞比率与困倦程度相关。
本研究强调了具有多种症状的COPD患者之间的异质性，从而识别出两个不同的症状亚组。解决悲伤和困倦症状可能是减轻COPD患者总体症状负担至关重要的目标。
