The Relationship Of C-reactive Protein And Acute Phase Of Chronic Obstructive Pulmonary Disease.

Objective:The aim of this study is to determine the relationship between the serum C-reactive protein (CRP ) levels and factors known to predict outcome in the patients with acute aggressive period of chronic obstructive pulmonary disease (COPD) and to confirm the value of its clinic application. Whether the serum CRP levels of those who smoke will become more higher than those do not smoke and different therapeutic method-using corticosteroid or do not use corticosteroid have also been observed.Methods: we recruited 118 patients admitted to the second Department of Respiratory Medicine, the First Affiliated Hospital of Kunming Medical College with a primary diagnosis of acute exacerbation of COPD(AECOPD), patients were categorized as COPD, who defined according to our country 2002's Diag-nose And Treatment Standard for COPD. WBC,ESR,high-sensitivity serum CRP were detected , chest X-ray were taken, Pulmonary Function Test performed,observed the highes temperature, when the patients just visited and after the treatmeat with effective antibiotics to compare the change. Control subjects consisted of 96 healthy persons who have taken regular physical examination.They had no history of COPD, confirmed by Pulmonary Function Test performed during the screening process. They have been grouped two group bases whether smoking. And the patients are divided into two-groups bases on the therapeutic methods as well who used corticosteroid is called the group of corticosteroid and who did not use corticosteroid is called no-corticosteroid group. Blood samples for CRP measurement were taken as soon as the patient admitted in the morning.Measurement was performed using a high-sensit-ivity CRP assay.Clinical assessments included a complete medical history (Interview and Physical exam included), Pulmonary Function Test, and high-sensitivity serum CRP, and so on. After gain all scores use SPSS 12．0 version statistical software to analysis these data. Resulst: Serum CRP levels were significantly higher in COPD patients than in controls (P<0．01) , but similar in both control groups (P>0．001) .The positive rate of serum CRP levels of with acute aggressive period of COPD is 96．61%. This result is higher in evidence than other items (WBC,N,ESR,X-ray examination of chest ), and the difference was obvious (P<0．001) , At the same time , after therapy, the serum CRP levels of the patients is dropped in evidence, as well the CRP's difference between before and after the use of antibiotics was obvious(P < 0．01 ). CRP levels were elevated in COPD patients without independent of cigarette smoking (P>0．001) . In the COPD patient, the serum CRP levels of the corticosteroid group is same as those of the no-corticosteroid group(P>0．001) . Patients' forced expiratory volume in one second ( FEV₁ )and FEV1/FVC (forced vital capacity) manifested the negative association with CRP levels in Acute Phase of chronic obstructive pulmonary disease patients.Conclusion: CRP levels were elevated in COPD patients without independent of cigarette smoking and corticosteroid use. Patients' FEV₁ and FEV₁/FVC manifested the negative association with CRP levels in Acute Phase of chronic obstructive pulmonary disease patients. CRP is a sensitive and specific index to the acute aggressive chronic obstructive pulmonary disease. C-reactive protein levels are measured in acute exacerbation of chronic obstructive pulmonary disease (AECOPD)patients, and is helpful to discover this acute disease early as well as a good guide to the use of antibiotics .CRP is exceller than other items (WBC,N,ESR,X-ray examination of chest ), and is availed to diagnose disease and estimation prognosis. we conclude that CRP may be a systemic marker of the inflammatory process that occurs in patients with COPD.