Wang Haijun, Cho Peter S P, Kouritas Vasileios, Feng Lanfang
Department of Respiratory Medicine, Dongyang People's Hospital, Dongyang, China.
Department of Respiratory Medicine, King's College Hospital, London, UK.
J Thorac Dis. 2025 Apr 30;17(4):2386-2393. doi: 10.21037/jtd-2025-416. Epub 2025 Apr 28.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a significant disease, and the main burden on global human health and economy. Currently, the pulmonary function test is the most common method for diagnosing AECOPD in clinical practice. The three levels (Grade I, II and III) of AECOPD exhibit different clinical characteristics and have a significant impact on the treatment and prognosis of patients. This study examined the correlation between serum lactic acid, pre-albumin, and lymphocyte levels, and the severity of AECOPD.
A total of 261 patients with AECOPD were divided into the following three grades: Grade I: patients without respiratory failure. Grade II: patients with non-life-threatening respiratory failure; and Grade III: patients with life-threatening respiratory failure. The serum markers of the patients were analyzed. Flow cytometry was used to identify T, B, and natural killer (NK) lymphocyte subgroups, while immunoturbidimetry and an enzyme-linked immunosorbent assay (ELISA) were used to detect pre-albumin and lactic acid levels, respectively.
Cluster of differentiation (CD)3 T cells, CD4 T cells, and the CD4/CD8 ratio were significantly higher in the Grade I group, while CD19 B cells were significantly lower in the Grade II group. The Grade I group also had higher levels of CD56 cells than the Grade III group. Serum pre-albumin levels were significantly lower in Grade II and III groups, while serum lactate levels were significantly higher in the Grade III group. C-reactive protein (CRP) levels were also higher in the Grade II group.
Serum pre-albumin, lactate, and lymphocyte levels were found to be closely related to the severity of AECOPD, and could be potential biomarkers for clinical diagnosis.
慢性阻塞性肺疾病急性加重（AECOPD）是一种重大疾病，是全球人类健康和经济的主要负担。目前，肺功能测试是临床实践中诊断AECOPD最常用的方法。AECOPD的三个级别（I级、II级和III级）表现出不同的临床特征，对患者的治疗和预后有重大影响。本研究探讨了血清乳酸、前白蛋白和淋巴细胞水平与AECOPD严重程度之间的相关性。
总共261例AECOPD患者被分为以下三个级别：I级：无呼吸衰竭的患者。II级：无危及生命的呼吸衰竭的患者；III级：有危及生命的呼吸衰竭的患者。对患者的血清标志物进行分析。采用流式细胞术鉴定T、B和自然杀伤（NK）淋巴细胞亚群，同时分别采用免疫比浊法和酶联免疫吸附测定（ELISA）检测前白蛋白和乳酸水平。
I级组分化簇（CD）3 T细胞、CD4 T细胞和CD4/CD8比值显著更高，而II级组CD19 B细胞显著更低。I级组的CD56细胞水平也高于III级组。II级和III级组的血清前白蛋白水平显著更低，而III级组的血清乳酸水平显著更高。II级组的C反应蛋白（CRP）水平也更高。
发现血清前白蛋白、乳酸和淋巴细胞水平与AECOPD的严重程度密切相关，可能成为临床诊断的潜在生物标志物。
