Kim Tae Hoon, Oh Dong Kyu, Oh Yeon-Mok, Lee Sei Won, Do Lee Sang, Lee Jae Seung
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
J Thorac Dis. 2018 Sep;10(9):5260-5268. doi: 10.21037/jtd.2018.08.52.
Under the Food and Drug Administration's drug development tool qualification program, fibrinogen is the first biomarker drug development tool used in chronic obstructive pulmonary disease (COPD). However, the correlation between fibrinogen and exacerbations among Korean patients with COPD remains unclear.
In this retrospective cross-sectional study, we included patients with COPD for whom plasma fibrinogen assessment results, without exacerbation, were available. Then, we compared subgroups according to fibrinogen level (threshold: 350 mg/dL). We used multivariate linear regression analysis to investigate the clinical phenotype of COPD with high fibrinogen level, analyzed the correlation between the COPD severity indexes and fibrinogen level.
Of 140 patients, we confirmed 48 (34.3%) patients in the high-level fibrinogen group. The high-level group demonstrated a medical history of more exacerbations than the low-level group. Lung functions [forced expiratory volume in 1 s (FEV), forced vital capacity, and 6-minute walk distance] were more deteriorated in the high-level group. Multivariate regression analysis revealed that fibrinogen level was associated with high COPD assessment test score, and experience of exacerbation. Fibrinogen level exhibited a statistically significant positive correlation with COPD severity indexes.
High fibrinogen level seems to reflect frequent exacerbation and severe symptomatic phenotypes in Korean patients with COPD.
在食品药品监督管理局的药物研发工具资格认定计划下，纤维蛋白原是慢性阻塞性肺疾病（COPD）中首个被用作生物标志物的药物研发工具。然而，韩国COPD患者中纤维蛋白原与病情加重之间的相关性仍不明确。
在这项回顾性横断面研究中，我们纳入了有血浆纤维蛋白原评估结果且无病情加重的COPD患者。然后，我们根据纤维蛋白原水平（阈值：350mg/dL）对亚组进行比较。我们使用多变量线性回归分析来研究高纤维蛋白原水平的COPD患者的临床表型，分析COPD严重程度指标与纤维蛋白原水平之间的相关性。
在140例患者中，我们确认了48例（34.3%）纤维蛋白原水平高的患者。高纤维蛋白原水平组的病情加重病史比低纤维蛋白原水平组更多。高纤维蛋白原水平组的肺功能[1秒用力呼气量（FEV）、用力肺活量和6分钟步行距离]更差。多变量回归分析显示，纤维蛋白原水平与高COPD评估测试评分以及病情加重经历有关。纤维蛋白原水平与COPD严重程度指标呈统计学显著正相关。
高纤维蛋白原水平似乎反映了韩国COPD患者频繁的病情加重和严重的症状表型。
