Sin Don D, Man S F Paul
James Hogg iCAPTURE Center for Cardiovascular and Pulmonary Research, St. Paul,s Hospital, Vancouver, Canada.
Can J Physiol Pharmacol. 2007 Jan;85(1):141-7. doi: 10.1139/y06-093.
Cardiovascular diseases and cancer (especially lung cancer) are leading causes of morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD). Some have implicated systemic inflammation, which is commonly observed in COPD, as the potential mechanistic bridge between COPD and these disorders. This concept has been supported by animal studies especially in rabbits, which have clearly demonstrated the effect of local lung inflammation on systemic inflammation and on the progression of atherosclerosis and by cross-sectional population-based studies, which have shown a significant relationship between systemic inflammation, as measured by circulating C-reactive protein (CRP) and the risk of cardiovascular diseases in COPD patients. These data have been further extended by a recent study that has elucidated the temporal nature of the relationship between systemic inflammation and the risk of cardiovascular events and cancer in COPD patients. This study showed that baseline CRP levels predicted the incidence of cardiovascular events and cancer-specific mortality over 7 to 8 years of follow-up. CRP levels also predicted all-cause mortality. Collectively, these data indicate that systemic inflammation may play an important role in mediating the extra-pulmonary complications of COPD. Systemic inflammation may contribute substantially to the overall morbidity and mortality of COPD patients.
心血管疾病和癌症（尤其是肺癌）是慢性阻塞性肺疾病（COPD）患者发病和死亡的主要原因。一些研究认为，COPD中常见的全身炎症是COPD与这些疾病之间潜在的机制桥梁。这一概念得到了动物研究的支持，尤其是在兔子身上的研究，这些研究清楚地证明了局部肺部炎症对全身炎症以及动脉粥样硬化进展的影响；此外，基于人群的横断面研究也表明，以循环C反应蛋白（CRP）衡量的全身炎症与COPD患者心血管疾病风险之间存在显著关系。最近一项研究进一步拓展了这些数据，该研究阐明了COPD患者全身炎症与心血管事件和癌症风险之间关系的时间特性。这项研究表明，基线CRP水平可预测7至8年随访期内心血管事件的发生率和癌症特异性死亡率。CRP水平还可预测全因死亡率。总体而言，这些数据表明全身炎症可能在介导COPD的肺外并发症中起重要作用。全身炎症可能在很大程度上导致COPD患者的总体发病率和死亡率。
