Three key factors predicting the severity of exacerbations of chronic obstructive pulmonary disease: T lymphocytes, lactate, and prealbumin.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.