Liang Ying, Chang Chun, Zhu Hong, Shen Ning, He Bei, Yao Wanzhen
Department of Respiratory Medicine, Peking University Third Hospital, North Garden Road No. 49, Haidian District, Beijing, 100191, China.
Intern Emerg Med. 2015 Sep;10(6):685-91. doi: 10.1007/s11739-015-1228-2. Epub 2015 Mar 31.
Circulating C-reactive protein (CRP) plays an important role in mediating extra-pulmonary complications of chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between changes in high sensitivity (hs)-CRP levels and the resolution of airway inflammatory markers and clinical health status during the recovery period after an acute exacerbation of COPD (AECOPD). Consecutive patients hospitalized for AECOPD were recruited. Serum hs-CRP, airway inflammatory markers, and COPD Assessment Test (CAT) score were evaluated at admission prior to treatment and at days 4, 7, and 14. Adverse outcomes were recorded. The relationship between changes in airway inflammatory markers, CAT score, and hs-CRP during the recovery period was studied. A total of 135 patients were enrolled. Serum hs-CRP levels at admission of patients with adverse outcomes were marginally higher than those without an adverse outcome (7.6 [4.8, 16.7] vs. 6.6 [4.7, 9.3], p = 0.061). Compared with patients without cardiovascular complications, patients with cardiovascular complications had higher serum hs-CRP levels at admission (11.6 [6.7, 16.7] vs. 6.6 [4.4, 10.0], p = 0.001). Sputum neutrophils were positively correlated to hs-CRP at admission (r = 0.474, p < 0.001). A decreasing hs-CRP level was positively related to decreasing sputum neutrophils at day 4 and 7 (r = 0.455, p < 0.001; r = 0.504, p < 0.001, respectively). Significant correlations between decreasing hs-CRP and CAT at all time-points were noted. Hs-CRP may be useful in monitoring airway inflammation resolution and improvement of health status during AECOPD treatment.
循环C反应蛋白（CRP）在介导慢性阻塞性肺疾病（COPD）的肺外并发症中起重要作用。本研究旨在探讨慢性阻塞性肺疾病急性加重期（AECOPD）恢复期高敏（hs）-CRP水平变化与气道炎症标志物消退及临床健康状况之间的关系。招募因AECOPD住院的连续患者。在治疗前入院时以及第4、7和14天评估血清hs-CRP、气道炎症标志物和慢性阻塞性肺疾病评估测试（CAT）评分。记录不良结局。研究了恢复期气道炎症标志物、CAT评分和hs-CRP变化之间的关系。共纳入135例患者。有不良结局患者入院时的血清hs-CRP水平略高于无不良结局患者（7.6 [4.8, 16.7] 对比 6.6 [4.7, 9.3]，p = 0.061）。与无心血管并发症的患者相比，有心血管并发症的患者入院时血清hs-CRP水平更高（11.6 [6.7, 16.7] 对比 6.6 [4.4, 10.0]，p = 0.001）。入院时痰中性粒细胞与hs-CRP呈正相关（r = 0.474，p < 0.001）。hs-CRP水平下降与第4天和第7天痰中性粒细胞减少呈正相关（分别为r = 0.455，p < 0.001；r = 0.504，p < 0.001）。在所有时间点均观察到hs-CRP下降与CAT之间存在显著相关性。Hs-CRP可能有助于监测AECOPD治疗期间气道炎症的消退和健康状况的改善。
