The Changes And Ciinical Implications Of Serum Amyloid A(SAA)in Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective To investigate the implications of serum amyloid A (SAA) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods A total of46patients with an acute exacerbation of COPD were studied. On presentation,serum SAA, CRP concentrations and WBC were measured, and quantitative sputum culture was also performed. The patients were reevaluated when they had returned to their stable clinical state.Potentially pathogenic microorganism (PPM) was only regarded as significant if they reached a growth of≥107CFU/ml indicating the presence of bacterial exacerbation of COPD. The patients were classified into two groups:group A included patients with bacterial exacerbation of COPD (n=16), group B included patients with nonbacterial exacerbation of COPD (n=30).16cases in the control group.Result (1)on presentation, sputum samples from22(47.8%)patients checked PPM. Besides16cases sputum PPM≥107CFU/ml。 when reevaluated in stable clinical state, sputum Samples7(15.2%) patients had a positive PPM culture [2.3x106(1.5x106,2.0x107)CFU/ml], but with a significantly lower bacterial load than on presentation[7.3×106(3.9×107,7.4×108) CFU/ml, Z=-2.663, P=0.008].(2) During acute exacerbation, the levels of SAA to group A and group B were higher than healthy controls. The levels of SAA were significantly higher than hsCRP in group A. When they returned to their stable state,the levels of SAA for patients of group A decreased to5.9mg/L, which were significantly lower than in exacerbation (q=4.96, p<0.01); But compared with exacerbation,the levels of SAA of group B did not changed (t=1.45, p>0.05).Conclusion The elevation of-serum SAA is associated with bacterial infection in. patients suffered from acute exacerbation of COPD...