Antonescu-Turcu Andreea L, Tomic Rade
Pulmonary Department, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA.
Curr Opin Pulm Med. 2009 Mar;15(2):120-5. doi: 10.1097/MCP.0b013e3283218603.
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a natural event in the course of COPD and remains a major cause of morbidity and mortality associated with this disease. Clinical criteria that define an acute exacerbation are subjective and open for debate. Identifying biomarkers that would be easily measured and followed in patients with acute exacerbation of COPD seems to be highly attractive. The aim of this review is to assess the role of biomarkers, C-reactive protein (CRP) and copeptin, as prognostic predictors in COPD exacerbations.
Many pulmonary biomarkers have been extensively studied in the recent years. CRP and copeptin have gained particular interest. Recent data suggest that CRP is elevated during an acute exacerbation of COPD but CRP alone is neither sensitive nor specific in predicting clinical severity or outcome. Copeptin increases during acute exacerbation of COPD and may correlate with disease severity.
Further studies are needed to determine the role of CRP and copeptin as biomarkers that aid in diagnosis and clinical outcome in acute exacerbation of COPD.
慢性阻塞性肺疾病(COPD)急性加重是COPD病程中的自然事件,仍是该疾病发病和死亡的主要原因。定义急性加重的临床标准具有主观性且存在争议。识别可在COPD急性加重患者中轻松测量和追踪的生物标志物似乎极具吸引力。本综述的目的是评估生物标志物、C反应蛋白(CRP)和 copeptin 作为COPD加重预后预测指标的作用。
近年来,许多肺部生物标志物得到了广泛研究。CRP 和 copeptin 尤其受到关注。近期数据表明,COPD 急性加重期间 CRP 升高,但单独的 CRP 在预测临床严重程度或预后方面既不敏感也不特异。Copeptin 在 COPD 急性加重期间升高,可能与疾病严重程度相关。
需要进一步研究以确定 CRP 和 copeptin 作为有助于COPD急性加重诊断和临床预后的生物标志物的作用。