The Relationship Between Serum Amyloid A And Acute Exacerbations Of Chronic Obstructive Pulmonary Disease And Its Clinic Significance

Objective :To investigate the changes of SAA,CRP levels and their relationship with the severity ,clinical outcomes in AECOPD required hospitalization.Method:Total 56 cases of AECOPD were selected, SAA and CRP were detected respectively on the time of admission ,resolution of AECOPD and stable period; baseline SAA and CRP values were obtained in 15 healthy volunteers. SAA and CRP were also detected in 10 patients after 24 hours of the treatmen of glucocorticoids in order to tested whether steroids acutely altered biomarker levels; According to severity Grading of AECOPD(ATS/ERS, patients were divided into two groups: level I/II and level III group;Patients were divided into two groups-resolution and treatment failure group based on the treatment outcomes. According to sputum culture outcomes, patients were divided into two groups: positive and negative group Analysed the changes of SAA and CRP levels and the relationships with AECOPD severity ,treatment outcome,sputum culture outcomes,hospitalization time, and clinical characteristics.Results:(1) SAA, CRP levels on admission were significantly higher than the resolution period ,the stability period and the normal group (P <0.05),No significant difference in SAA,CRP levels was observed between pre- and post-steroid samples(P>0.05); (2) SAA of level III group on admission was significantly higher than level I/II group(P <0.05);while no significant difference in CRP levels (P> 0.05);(3) SAA levels on admission according to treatment failure group was significantly higher than resolution group(P<0.05), there is no significant difference in CRP levels (both P values> 0.05), 3 cases of death in treatment failure group, its SAA levels on admission were significantly in high level position.; (4) there is no significant difference in SAA,CRP levels between sputum culture positive and negative groups;(5) there was a positive association between the length of hospital stay and SAA levels on admission, whereas CRP levels on admission have no such correlation; (5) there were not relationships between SAA,CRP levels on hospital admission and some patient characteristics (such as age , gender ,smoking index, Duration of COPD, leukocyte count, FEV1% pred on admission).Conclusions:Our data shows that the SAA ,CRP levels in AECOPD significantly increased, SAA levels on admission are related to the severity of AECOPD and clinical outcomes( such as length of hospital stay and treatment outcome: resolution ,need for ICU treatment,or mortality), whereas CRP levels have no such correlation ,Suggesting SAA could be used as a inflammation marker for AECOPD.