慢性阻塞性肺疾病患者超敏C反应蛋白与纤维蛋白原含量的变化及其临床意义

The Changes and Their Clinical Significance of Serum High-Sensitivity C-Reactive Protein (hs-CRP) and Plasma Fibrinogen (Fib) in COPD Patients

摘要: 目的：探讨慢性阻塞性肺疾病急性加重期(AECOPD)及慢性阻塞性肺疾病稳定期(stable COPD, SCOPD)患者血清超敏C反应蛋白(High-sensitivity C-reactive protein, hs-CRP)、纤维蛋白原(plasma Fibrino-gen, Fib)含量变化及临床意义。方法：采用病例对照组研究设计，选取我院呼吸内科自2015年12月-2016年12月收治的AECOPD组患者80例，将此AECOPD组患者经治疗病情稳定达1个月以上的患者纳入SCOPD组，共35例，分别于早晨抽取空腹静脉血，检测hs-CRP、Fib，对照组选取同时间段的健康体检者75例，于体检中心早晨抽取空腹静脉血检测hs-CRP、Fib，比较其水平差异；同时测定AECOPD组、SCOPD组患者的第一秒用力呼气容积占预计值百分比(FEV1%pred)及第一秒用力呼气容积与用力肺活量的比值(FEV1/FVC(%))水平，分析血清hs-CRP、Fib水平与FEV1%pred及FEV1/FVC(%)的相关性。结果：AECOPD组、SCOPD组、健康对照组的血清hs-CRP、Fib水平分别为((15.23 ± 7.01) mg/L, (4.79 ± 1.31)g/L)、((3.61 ± 2.84) mg/L, (3.87 ± 1.63) g/L)、((1.76 ± 1.25) mg/L (3.03 ± 0.44)g/L)，AECOPD组血清hs-CRP、Fib水平均高于SCOPD组及健康对照组，差异有统计学意义(p<0.05)；SCOPD组hs-CRP、Fib水平高于对照组，差异有统计学意义(p < 0.05)；AECOPD组FEV1%pred及FEV1/FVC(%)分别为(47.30 ± 15.57) (52.63 ± 14.83)，SCOPD组FEV1%pred及FEV1/FVC(%)分别为(52.63 ± 14.83) (59.36 ± 4.19)。SCOPD组FEV1/FVC(%)水平高于AECOPD组，差异具有统计学意义(p < 0.05)；两组的FEV1%pred水平比较，差异无统计学意义(p > 0.05)；COPD患者血清hs-CRP、Fib水平与FEV1%pred均呈负相关(r分别等于−0.69，−0.78，均p < 0.05)；与FEV1/FVC(%)比较呈负相关(r = −0.58, −0.44, p < 0.05)。结论：血清hs-CRP、Fib水平可作为预测COPD病情加重的参考指标，对改善预后有重要意义。

Abstract: Objective: To investigate the changes of serum high-sensitivity C-reactive protein (hs-CRP) and plasma Fibrinogen (Fib) in patients with acute exacerbation of chronic obstructive pulmonary dis-ease (COPD). Method: A case control study was carried out on 80 cases of the AECOPD patients ad-mitted Respiratory Medicine of our hospital since December 2015 to December 2016. Forty five AECOPD patients (AECOPD group), thirty five patients with COPD at stable phase (SCOPD group), se-venty five healthy people (control group) were selected in this study. And their hs-CRP and plasma Fib in serum were tested, the differences in three groups were compared. Meanwhile, their FEV1%pred and FEV1/FVC(%) also be measured. Results: The level of hs-CRP and Fib in AECOPD group, SCOPD group, control group were [(15.23 ± 7.01) mg/L, (4.79 ± 1.31) g/L], [(3.61 ± 2.84) mg/L, (3.87 ± 1.63) g/L], [(1.76 ± 1.25) mg/L (3.03 ± 0.44) g/L]. The level of serum hs-CRP and Fib were significantly increased in patients with AECOPD as compared with controls and stable COPD (p < 0.05). Comparison between stable COPD and control group about serum levels of hs-CRP and Fib had significant difference (p < 0.05). The levels of FEV1%pred and FEV1/FVC(%) in AECOPD group and SCOPD group were (47.30 ± 15.57) (52.63 ± 14.83), (52.63 ± 14.83) (59.36 ± 4.19) respectively. FEV1/FVC(%) levels were significantly increased in AECOPD group compared with SCOPD group (p < 0.05). Compared with their FEV1%pred levels, there were no significant differences (p > 0.05). The hs-CRP, Fib were negatively correlated with the FEV1%pred (r = −0.69, −0.78, p < 0.05). They were also negatively correlated with the FEV1/FVC(%) (r = −0.58, −0.44, p < 0.05). Conclusion: The levels of hs-CRP and Fib can be good indicators in the diagnosis and condition monitoring of COPD.