| Background: Chronic obstructive pulmonary disease is a disease with limited flow characteristics, and limited flow is not completely reversible and the progressive development. The pathological basischronic are chronic inflammation of airway wall and lung parenchyma and the structural damage, ultimately leading to luminal stenosis, airway remodelling, increased airway resistance and pulmonary emphysema formation. COPD is a kind of lung disease which can be prevented and treatded, mainly displaying in lung disease, accompanied by significant extrapulmonary effects at the same time. These extrapulmonary effects have significant impact in the seriousness of the disease, and can directly reflect the severity of the disease. COPD is the fourth death cause in the world, as one of the emphases on the prevention and control of chronic diseases in the world, caused the attention of the countries all over the world. The world health organization announced that COPD is the fifth largest economic burden disease, the third global cause of death in the world by 2020 and will become the first economic burden disease in our country. The latest statistics showed that the prevalence of COPD accounted for 8.2% of people aged above 40 years old. COPD is associated with abnormal inflammation for the harmful gases or particles, characterized by chronic inflammation in the airway, lung parenchyma and pulmonary vascular. Inflammation can lead to mucosal edema, hypertrophy, secretion, bronchospasm, smooth muscle hypertrophy and airway wall fibrosis. Airway remodeling caused air limited irreversible. Thus, Chronic inflammation of lung plays an extremely important role in the occurrence and development of COPD. And, Recurring chronic inflammation can also cause many activation of inflammatory cells, and release a variety of inflammatory mediators, some biological factors also can cause systemic adverse effects. Now that COPD was a pulmonary inflammatory disease and a systemic inflammatory disease. The clinical diagnosis of acute exacerbation chronic obstructive pulmonary diseases mainly depended on the patient’s clinical manifestations, strong subjective factors and the lack of objective indicators which can be diagnosed. And it is a kind of exclusive disease. Current studies have found that inflammatory biomarkers can be used as the auxiliary quantitative diagnosis of acute exacerbation chronic obstructive pulmonary diseases, such as c-reactive protein, fibrinogen, etc. and reacted to inflammation of chronic obstructive pulmonary disease. However the existing inflammatory markers have some shortcomings. Red blood cell distribution width reflects the size of red blood cell heterogeneity, was closely related to the lack of oxygen and the body inflammation. Its clinical value rarely reported in the acute exacerbation chronic obstructive pulmonary diseases. Objective: This study intends to discuss the changes of red blood cell distribution width(RDW), C-reactive protein(CRP) and fibrinogen(FIB) levels of patients in Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD) before and after treatment, and the correlation to inflammatory biomarkers of CRP, fibrinogen to explore the role of the inflammatory factors in the pathogenesis of COPD, and reveal the red blood cell distribution width in the diagnosis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD). Through the observation of correlation between RDW, CRP, fibrinogen level and pulmonary artery systolic pressure in patients of Acute Exacerbation of Chronic Obstructive Pulmonary Disease, to reveal the relationship between RDW and the severity of COPD, as to provide theoretical basis for the prevention and treatment of COPD. Methods: 40 cases of the AECOPD patients were collected in the second people’s hospital of Wu Hu respiratory medicine ward since June 2014 to December 2014, sampled blood in the next morning after admission(acute aggravating stage) and on the day of discharge(remission stage) to test RDW, CRP and FIB levels. 40 cases of normal physical examination were the control group. At the same time systolic pulmonay artery pressure(SPAP) of 40 COPD patients were measured by doppler echocardiography on the day of admission to hospital. Result: The serum RDW levels of acute aggravating group and stable group respectively were 13.52±1.10 vs 10.80±0.85. The serum RDW levels of acute aggravating group increased obviously compared to stable group, which was statistically significant(P < 0.05); The serum CRP levels of acute aggravating group and stable group respectively were 31.32±3.35 vs 3.96±2.20. The serum CRP levels of acute aggravating group increased obviously compared to stable group, which was statistically significant(P < 0.05); The serum fibrinogen levels of acute aggravating group increased obviously compared to stable group, respectively were 5.46±0.24 vs 3.28±0.36,and was statistically significant(P < 0.05);The serum RDW, CRP and FIB levels of stable group were higher than control group and were statistically significant(P < 0.05). RDW, CRP and FIB levels in patients with acute exacerbation of COPD had a significant positive correlation and correlation coefficient respectively were 0.65(P <0.01),0.34(P <0.02). RDW levels in patients with acute exacerbation of COPD had a significant positive correlation with pulmonary arterial hypertension(r=0.78, P<0.001), but CRP and FIB levels had no correlation with pulmonary artery pressure(r=-0.18, P=0.26;r=0.16, P=0.32). Conclusion: RDW can be used as sensitivity index of reaction COPD exacerbations and severe degree. Combined detection of changes in the levels of in CRP and FIB of COPD patients has very important role in diagnosis of acute exacerb ation of COPD and judgment of the therapeutic effectiveness. |
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