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稳定期慢性阻塞性肺疾病患者的 C 反应蛋白水平升高,与吸烟行为和生物量暴露无关。

C-reactive protein levels are raised in stable Chronic obstructive pulmonary disease patients independent of smoking behavior and biomass exposure.

机构信息

Department of Chest Diseases, Atatürk Chest Diseases and Surgery Training and Education Hospital, Ankara 06290, Turkey;

出版信息

J Thorac Dis. 2013 Aug;5(4):414-21. doi: 10.3978/j.issn.2072-1439.2013.06.27.

Abstract

BACKGROUND

The aim of this case control study is to assess the relationship between serum C-reactive protein (CRP) levels and well-known clinical parameters in Chronic obstructive pulmonary disease (COPD) considering the impact of smoking behavior, biomass exposure and accompanying clinical entities, namely pulmonary hypertension, systemic hypertension and diabetes mellitus.

METHODS

Spirometry, echocardiography, arterial oxygen saturation (SpO2) measurements, BODE scores and serum CRP levels were investigated in stable COPD patients. Associations between CRP levels and clinical parameters were evaluated.

RESULTS

CRP levels are significantly higher in COPD patients than in healthy controls. CRP levels were not significantly different between COPD patients treated with inhaled corticosteroids and those not treated. CRP levels significantly correlated with age, FEV1% predicted, FVC% predicted, SpO2, MMRC, 6 minute walk distance, BODE scores and haemoglobin levels. In multivariate analysis BODE scores and concomitant systemic hypertension manifested the strongest association with CRP levels. CRP levels in COPD patients with and without pulmonary hypertension were significantly different. CRP levels did not differ significantly according to smoking status or biomass exposure, moreover COPD cases due to biomass exposure who never smoked also had higher CRP levels compared to healthy controls.

CONCLUSIONS

Systemic inflammation is inherent to COPD independent of ever-smoking status and correlates with disease severity, concomitant systemic hypertension and pulmonary hypertension.

摘要

背景

本病例对照研究旨在评估慢性阻塞性肺疾病(COPD)患者血清 C 反应蛋白(CRP)水平与众所周知的临床参数之间的关系,同时考虑吸烟行为、生物量暴露以及伴随的临床实体(即肺动脉高压、系统性高血压和糖尿病)的影响。

方法

对稳定期 COPD 患者进行肺功能检查、超声心动图、动脉血氧饱和度(SpO2)测量、BODE 评分和血清 CRP 水平检测。评估 CRP 水平与临床参数之间的相关性。

结果

COPD 患者的 CRP 水平明显高于健康对照组。接受吸入皮质激素治疗和未接受治疗的 COPD 患者的 CRP 水平无显著差异。CRP 水平与年龄、FEV1%预计值、FVC%预计值、SpO2、MMRC、6 分钟步行距离、BODE 评分和血红蛋白水平显著相关。多元分析显示,BODE 评分和合并的系统性高血压与 CRP 水平的相关性最强。有和没有肺动脉高压的 COPD 患者的 CRP 水平有显著差异。CRP 水平与吸烟状况或生物量暴露无显著差异,此外,从不吸烟的因生物量暴露而患 COPD 的患者的 CRP 水平也明显高于健康对照组。

结论

系统性炎症是 COPD 的固有特征,与是否吸烟无关,与疾病严重程度、合并的系统性高血压和肺动脉高压相关。

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