慢性阻塞性肺病临床表型中全身炎症标记物的比较研究

Q3 Medicine
Tanaffos Pub Date : 2023-02-01
Manjushree Sonar, Basavaraju Tejur Jayadeva, B L Shashibhushan
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引用次数: 0

摘要

背景:慢性阻塞性肺疾病(COPD)是一种具有全身炎症表现的炎症性肺部疾病。本研究旨在确定慢性阻塞性肺病不同表型的全身炎症标志物概况,以帮助预测病情并确定合适的治疗方案:这项前瞻性观察研究针对班加罗尔维多利亚医院在 2021 年 8 月至 2021 年 12 月期间收治的 92 名慢性阻塞性肺病患者。研究人员在患者入院 48 小时内测量了其 C 反应蛋白 (CRP)、血清肌酐、红细胞沉降率 (ESR)、淋巴细胞绝对计数 (ALC)、嗜酸性粒细胞绝对计数 (AEC) 和乳酸脱氢酶 (LDH) 的水平:结果:频繁加重肺气肿患者和慢性支气管炎患者的 CRP 水平明显更高(P=0.001)。频繁恶化型肺气肿患者的 LDH 水平(P=0.001)和血清肌酐水平(P=0.001)明显更高。嗜酸性粒细胞绝对计数在 COPD-哮喘重叠表型中明显升高(p=0.001),这也不足为奇:结论:在肺气肿和慢性支气管炎的频繁恶化表型中,血清 CRP 水平升高表明可能存在感染性病因引起的炎症反应。频繁恶化型肺气肿表型中升高的 LDH 水平可能意味着潜在的肺实质破坏。全身炎症和氧化应激可导致慢性阻塞性肺病患者的骨骼肌损伤和萎缩。这可能解释了频繁恶化型肺气肿表型中血清肌酐水平升高的原因。嗜酸性粒细胞增多见于慢性阻塞性肺病-哮喘重叠表型,提示气道存在第二型炎症,对类固醇的反应较好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Study of Systemic Inflammatory Markers in Clinical Phenotypes of Chronic Obstructive Pulmonary Disease.

Background: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory pulmonary disorder with systemic inflammatory manifestations. This study aims to identify the profile of systemic inflammatory markers in the different phenotypes of COPD to help predict the disease and identify suitable treatment options.

Materials and methods: A prospective observational study was conducted on 92 patients with COPD admitted to Victoria Hospital, Bangalore between August 2021 to December 2021. Levels of C-reactive protein (CRP), Serum Creatinine, Erythrocyte Sedimentation Rate (ESR), Absolute Lymphocyte Count (ALC), Absolute Eosinophil Count (AEC), and Lactate Dehydrogenase (LDH) were measured within 48 hours of presentation.

Results: Significantly higher levels of CRP were found in frequent exacerbator emphysema and chronic bronchitis phenotypes (p=0.001). The frequent exacerbator emphysema phenotype had significantly higher levels of LDH (p=0.001) and serum creatinine (p=0.001). Not surprisingly, absolute eosinophil counts were significantly raised in the overlap COPD-Asthma phenotype (p=0.001).

Conclusion: Raised serum CRP levels in the frequent exacerbator phenotypes of emphysema and chronic bronchitis suggest a possible inflammatory response to an infective etiology. Raised LDH levels in frequent exacerbator emphysema phenotype could signify underlying lung parenchymal destruction. Systemic inflammation and oxidative stress can lead to skeletal muscle injury and atrophy in COPD patients. This may explain the raised serum creatinine levels in frequent exacerbator emphysema phenotype. Eosinophilia seen in Overlap COPD-Asthma phenotype is suggestive of type 2 inflammation of the airways with better response to steroids.

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Tanaffos
Tanaffos Medicine-Critical Care and Intensive Care Medicine
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