慢性阻塞性肺疾病急性加重期血液生物标志物的研究进展
Research Progress on Blood Biomarkers in Acute Exacerbation of Chronic Obstructive Pulmonary Disease
DOI: 10.12677/jcpm.2026.51011, PDF,   
作者: 孙晶雨:济宁医学院临床医学院(附属医院),山东 济宁;韩丽萍*:济宁市第一人民医院呼吸与危重症医学科,山东 济宁
关键词: 慢性阻塞性肺疾病血液标记物病情严重程度预后Chronic Obstructive Pulmonary Disease Blood Biomarkers Disease Severity Prognosis
摘要: 慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)简称慢阻肺,是一种进行性疾病,其主要特征是持续的气流受限、气道炎症以及全身效应或合并症。据统计,全世界约有5.45亿人患有COPD,是全球发病率和死亡率的第三大原因。慢性阻塞性肺疾病急性加重(Acute Exacerbation of Chronic Obstructive Pulmonary Disease, AECOPD)不仅并带来沉重的医疗保健费用负担,还会加速患者肺功能的丧失,显著增加其住院和死亡的风险。慢性阻塞性肺疾病发病机制复杂,近年来,有研究发现不同发病机制中血液生物学标志物在评估COPD严重程度及预后方面的存在潜在作用,因其客观、易获取的特性,在评估病情严重程度和预测预后方面展现出重要价值,本文将从血液生物学标志物对AECOPD严重程度的评估及预后影响进行综述。
Abstract: Chronic Obstructive Pulmonary Disease (COPD), often referred to as chronic obstructive lung disease, is a progressive condition characterized primarily by persistent airflow limitation, airway inflammation, and systemic effects or comorbidities. According to statistics, approximately 545 million people worldwide suffer from COPD, making it the third leading cause of morbidity and mortality globally. Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) not only imposes a heavy burden on healthcare costs but also accelerates the loss of patients’ lung function, significantly increasing their risk of hospitalization and death. The pathogenesis of COPD is complex. In recent years, studies have revealed the potential role of blood biomarkers in evaluating the severity and prognosis of COPD across different pathogenic mechanisms. Due to their objective and easily accessible nature, these biomarkers demonstrate significant value in assessing disease severity and predicting outcomes. This review will summarize the impact of blood biomarkers on the evaluation of AECOPD severity and prognosis.
文章引用:孙晶雨, 韩丽萍. 慢性阻塞性肺疾病急性加重期血液生物标志物的研究进展[J]. 临床个性化医学, 2026, 5(1): 67-73. https://doi.org/10.12677/jcpm.2026.51011

参考文献

[1] Yehia, D., Leung, C. and Sin, D.D. (2024) Clinical Utilization of Airway Inflammatory Biomarkers in the Prediction and Monitoring of Clinical Outcomes in Patients with Chronic Obstructive Pulmonary Disease. Expert Review of Molecular Diagnostics, 24, 409-421. [Google Scholar] [CrossRef] [PubMed]
[2] Kim, V., Rogers, T.J. and Criner, G.J. (2008) New Concepts in the Pathobiology of Chronic Obstructive Pulmonary Disease. Proceedings of the American Thoracic Society, 5, 478-485. [Google Scholar] [CrossRef] [PubMed]
[3] Jacobsen, E.A., Helmers, R.A., Lee, J.J. and Lee, N.A. (2012) The Expanding Role(s) of Eosinophils in Health and Disease. Blood, 120, 3882-3890. [Google Scholar] [CrossRef] [PubMed]
[4] Tashkin, D.P. and Wechsler, M.E. (2018) Role of Eosinophils in Airway Inflammation of Chronic Obstructive Pulmonary Disease. International Journal of Chronic Obstructive Pulmonary Disease, 13, 335-349. [Google Scholar] [CrossRef] [PubMed]
[5] Kwok, W.C., Tam, T.C.C., Chau, C.H., Lam, F.M. and Ho, J.C.M. (2025) Differences in Blood Eosinophil Level during Stable Disease and during Exacerbation of COPD and Exacerbation Risks. Lung, 203, Article No. 37. [Google Scholar] [CrossRef] [PubMed]
[6] Bafadhel, M., McKenna, S., Terry, S., Mistry, V., Reid, C., Haldar, P., et al. (2011) Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Identification of Biologic Clusters and Their Biomarkers. American Journal of Respiratory and Critical Care Medicine, 184, 662-671. [Google Scholar] [CrossRef] [PubMed]
[7] Bafadhel, M., Pavord, I.D. and Russell, R.E.K. (2017) Eosinophils in COPD: Just Another Biomarker? The Lancet Respiratory Medicine, 5, 747-759. [Google Scholar] [CrossRef] [PubMed]
[8] Feng, L., Li, J., Qian, Z., Li, C., Gao, D., Wang, Y., et al. (2024) Comprehensive Nomograms Using Routine Biomarkers Beyond Eosinophil Levels: Enhancing Predictability of Corticosteroid Treatment Outcomes in AECOPD. Journal of Inflammation Research, 17, 1511-1526. [Google Scholar] [CrossRef] [PubMed]
[9] Li, J., Liang, L., Feng, L., Cao, S., Cai, Y.S., Li, X., et al. (2023) The Prognostic Value of Blood Eosinophil Level in AECOPD Is Influenced by Corticosteroid Treatment during Hospitalization. Journal of Inflammation Research, 16, 3233-3243. [Google Scholar] [CrossRef] [PubMed]
[10] Hoult, G., Gillespie, D., Wilkinson, T.M.A., Thomas, M. and Francis, N.A. (2022) Biomarkers to Guide the Use of Antibiotics for Acute Exacerbations of COPD (AECOPD): A Systematic Review and Meta-Analysis. BMC Pulmonary Medicine, 22, Article No. 194. [Google Scholar] [CrossRef] [PubMed]
[11] Hurst, J.R., Donaldson, G.C., Perera, W.R., Wilkinson, T.M.A., Bilello, J.A., Hagan, G.W., et al. (2006) Use of Plasma Biomarkers at Exacerbation of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, 174, 867-874. [Google Scholar] [CrossRef] [PubMed]
[12] Munuswamy, R., De Brandt, J., Burtin, C., Derave, W., Aumann, J., Spruit, M.A., et al. (2021) Monomeric CRP Is Elevated in Patients with COPD Compared to Non-COPD Control Persons. Journal of Inflammation Research, 14, 4503-4507. [Google Scholar] [CrossRef] [PubMed]
[13] Gong, C., Yang, Y., Chen, M. and Xie, Z. (2020) Effect of Procalcitonin on the Prognosis of Patients with COPD. Biomedical Reports, 12, 313-318. [Google Scholar] [CrossRef] [PubMed]
[14] Carbonell, R., Moreno, G., Martín-Loeches, I., Bodí, M. and Rodríguez, A. (2023) The Role of Biomarkers in Influenza and COVID-19 Community-Acquired Pneumonia in Adults. Antibiotics, 12, Article 161. [Google Scholar] [CrossRef] [PubMed]
[15] Bateman, R.M., Sharpe, M.D., Jagger, J.E., et al. (2016) Crit Care. 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium, 15-18 March 2016, 94.
[16] Gautam, S., Cohen, A.J., Stahl, Y., Valda Toro, P., Young, G.M., Datta, R., et al. (2020) Severe Respiratory Viral Infection Induces Procalcitonin in the Absence of Bacterial Pneumonia. Thorax, 75, 974-981. [Google Scholar] [CrossRef] [PubMed]
[17] Bremmer, D.N., Moffa, M.A., Ma, K., Bean, H.R., Snatchko, J., Trienski, T.L., et al. (2019) Acute Exacerbations of Chronic Obstructive Pulmonary Disease with a Low Procalcitonin Concentration: Impact of Antibiotic Therapy. Clinical Infectious Diseases, 68, 725-730. [Google Scholar] [CrossRef] [PubMed]
[18] Ramya, P.A., Mohapatra, M.M., Saka, V.K., et al. (2023) Haematological and Inflammatory Biomarkers among Stable COPD and Acute Exacerbations of COPD Patients. Sultan Qaboos University Medical Journal, 23, 239-244. [Google Scholar] [CrossRef] [PubMed]
[19] Lan, C.C., Su, W.L., Yang, M.C., et al. (2023) Predictive Role of Neutrophil‐Percentage‐to‐Albumin, Neutrophil‐to‐Lymphocyte and Eosinophil‐to‐Lymphocyte Ratios for Mortality in Patients with COPD: Evidence from NHANES 2011-2018. Respirology, 28, 1136-1146. [Google Scholar] [CrossRef] [PubMed]
[20] Shi, Y., Shi, Y., Liu, Y., Wang, C., Qi, M. and Li, C. (2025) Association between Neutrophil Percentage to Serum Albumin Ratio and In-Hospital Mortality of Patients with Chronic Obstructive Pulmonary Disease in Intensive Care Unit: A Retrospective Cohort Study. International Journal of Chronic Obstructive Pulmonary Disease, 20, 1227-1237. [Google Scholar] [CrossRef] [PubMed]
[21] Shao, S., Zhang, Z., Feng, L., Liang, L. and Tong, Z. (2023) Association of Blood Inflammatory Biomarkers with Clinical Outcomes in Patients with AECOPD: An 8-Year Retrospective Study in Beijing. International Journal of Chronic Obstructive Pulmonary Disease, 18, 1783-1802. [Google Scholar] [CrossRef] [PubMed]
[22] Choi, Y.J., Kwon, D.S., Kim, T., Cho, J.H., Kim, H.J., Byun, M.K., et al. (2021) Low Alanine Aminotransferase as a Risk Factor for Chronic Obstructive Pulmonary Disease in Males. Scientific Reports, 11, Article No. 14829. [Google Scholar] [CrossRef] [PubMed]
[23] Lasman, N., Shalom, M., Turpashvili, N., Goldhaber, G., Lifshitz, Y., Leibowitz, E., et al. (2020) Baseline Low ALT Activity Is Associated with Increased Long-Term Mortality after COPD Exacerbations. BMC Pulmonary Medicine, 20, Article No. 133. [Google Scholar] [CrossRef] [PubMed]
[24] Wada, H., Ikeda, A., Maruyama, K., Yamagishi, K., Barnes, P.J., Tanigawa, T., et al. (2021) Low BMI and Weight Loss Aggravate COPD Mortality in Men, Findings from a Large Prospective Cohort: The JACC Study. Scientific Reports, 11, Article No. 1531. [Google Scholar] [CrossRef] [PubMed]
[25] Kim, E.K., Singh, D., Park, J.H., Park, Y.B., Kim, S., Park, B., et al. (2020) Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease. Respiration, 99, 943-953. [Google Scholar] [CrossRef] [PubMed]
[26] Irina, G., Refaela, C., Adi, B., Avia, D., Liron, H., Chen, A., et al. (2018) Low Blood ALT Activity and High FRAIL Questionnaire Scores Correlate with Increased Mortality and with Each Other. A Prospective Study in the Internal Medicine Department. Journal of Clinical Medicine, 7, Article 386. [Google Scholar] [CrossRef] [PubMed]
[27] Kim, H.W., Lee, S.H.F., Lee, D.H., et al. (2018) Relationship of Serum Gamma-Glutamyltransferase Levels with Pulmonary Function and Chronic Obstructive Pulmonary Disease. International Journal of Chronic Obstructive Pulmonary Disease, 13, 335-349.
[28] Sun, D., Liu, H., Ouyang, Y., Liu, X. and Xu, Y. (2020) Serum Levels of Gamma-Glutamyltransferase during Stable and Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Medical Science Monitor, 26, 1-7. [Google Scholar] [CrossRef] [PubMed]
[29] Du, W., Guan, H., Wan, X., Zhu, Z., Yu, H., Luo, P., et al. (2023) Circulating Liver Function Markers and the Risk of COPD in the UK Biobank. Frontiers in Endocrinology, 14, Article 1121900. [Google Scholar] [CrossRef] [PubMed]
[30] Ermis, H., Celik, M.R., Gulbas, G., Tavli, D. and Aytemur, Z.A. (2013) Relationship between Serum γ‑Glutamyltransferase Levels and Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Polish Archives of Internal Medicine, 123, 85-90. [Google Scholar] [CrossRef] [PubMed]
[31] Ruggiero, C., Cherubini, A., Ble, A., Bos, A.J.G., Maggio, M., Dixit, V.D., et al. (2006) Uric Acid and Inflammatory Markers. European Heart Journal, 27, 1174-1181. [Google Scholar] [CrossRef] [PubMed]
[32] Romi, M.M., Arfian, N., Tranggono, U., Setyaningsih, W.A.W. and Sari, D.C.R. (2017) Uric Acid Causes Kidney Injury through Inducing Fibroblast Expansion, Endothelin-1 Expression, and Inflammation. BMC Nephrology, 18, Article No. 328. [Google Scholar] [CrossRef] [PubMed]
[33] Spiropoulos, K., Trakada, G., Nikolaou, E., Prodromakis, E., Efremidis, G., Pouli, A., et al. (2003) Endothelin-1 Levels in the Pathophysiology of Chronic Obstructive Pulmonary Disease and Bronchial Asthma. Respiratory Medicine, 97, 983-989. [Google Scholar] [CrossRef] [PubMed]
[34] Elsayed, N.M., Nakashima, J.M. and Postlethwait, E.M. (1993) Measurement of Uric Acid as a Marker of Oxygen Tension in the Lung. Archives of Biochemistry and Biophysics, 302, 228-232. [Google Scholar] [CrossRef] [PubMed]
[35] Kir, E., Güven Atici, A., Güllü, Y.T., Köksal, N. and Tunçez, İ.H. (2021) The Relationship between Serum Uric Acid Level and Uric Acid/Creatinine Ratio with Chronic Obstructive Pulmonary Disease Severity (Stable or Acute Exacerbation) and the Development of Cor Pulmonale. International Journal of Clinical Practice, 75, Article 14303. [Google Scholar] [CrossRef] [PubMed]
[36] Fukuhara, A., Saito, J., Sato, S., Saito, K., Fukuhara, N., Tanino, Y., et al. (2017) The Association between Risk of Airflow Limitation and Serum Uric Acid Measured at Medical Health Check-Ups. International Journal of Chronic Obstructive Pulmonary Disease, 12, 1213-1219. [Google Scholar] [CrossRef] [PubMed]
[37] Bartziokas, K., Papaioannou, A.I., Loukides, S., Papadopoulos, A., Haniotou, A., Papiris, S., et al. (2013) Serum Uric Acid as a Predictor of Mortality and Future Exacerbations of COPD. European Respiratory Journal, 43, 43-53. [Google Scholar] [CrossRef] [PubMed]
[38] Gao, H., Wang, J., Zou, X., Zhang, K., Zhou, J. and Chen, M. (2022) High Blood Urea Nitrogen to Creatinine Ratio Is Associated with Increased Risk of Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease. Experimental Gerontology, 169, Article 111960. [Google Scholar] [CrossRef] [PubMed]
[39] Barmehziar, S., Fadaii, A., Samadian, F., Shakiba, A. and Koolaji, S. (2023) Investigating the Role of Uric Acid and Uric Acid-to-Creatinine Ratio as a Predictive Factor of Chronic Obstructive Pulmonary Disease Exacerbation in 2019. The Clinical Respiratory Journal, 17, 1025-1037. [Google Scholar] [CrossRef] [PubMed]