The Study Of Neutrophil Gelatinase-associated Lipocalin In Patients With COPD

Objective To examine the plasma levels of neutrophil gelatinase-associatedlipocalin(NGAL) in patients with acute elevated chronic obstructive pulmonary disease(AECOPD),stationary chronic obstructive pulmonary disease(SCOPD) and controlsubjects.To explore the relationship between the expression of NGAL andcharacteristics of AECOPD and search a new available avenue to assess and treatAECOPD.Methods We investigated57patients with AECOPD,30paitents with SCOPD and28control subjects. Plasma levels of NGAL and hsCRP were measured by enzyme-linkedimmunosorbent assay(ELISA). To obtain sputum by induced sputum and carry out totalcell counting and differential cell counting, NGAL of the supernatant were measured byenzyme-linked immunosorbent assay. We also examined pulmonary function bySpirometer, including Forced Volume Capacity(FVC), Forced Expiratory Volume in onesecond(FEV1),et al. We use automatic blood analyzers and blood gas analyzer testingblood and arterial blood gas. SPSS13.0software is used for data analysis, P <0.05wasconsidered statistically significant.Results Plasma NGAL level of chronic obstructive pulmonary disease acute phase andstationary phase and the control group were (105.32±17.11)μg/L、(74.36±14.29)μg/L、(58.76±10.68)μg/L,the difference among the three groups wasstatistically significant (P <0.01).CRP levels of three groups were (30.29±5.67) mg/L、(2.71±0.43) mg/L、(1.2±0.06) mg/L, the difference was statisticallysignificant (P <0.01).The number of plasma neutrophils of three groups were (5.24±2.68)*109/L、(4.08±1.12)*109/L、(3.21±0.99)*109/L, the difference wasstatistically significant (P <0.01). Arterial oxygen tension of three groups were (71.89±18.14)mmHg、(94.37±16.73)mmHg、(96.89±10.21)mmHg, the acute phasecompared with the control group, the stationary phase and control group difference wasstatistically significant (P <0.01). FEV1/FVC of three groups were(60.01±18.58)%、(62.44±12.25)%、(73.68±5.06)%, The acute phase compared with the control group,the stationary phase and control group difference was statistically significant (P <0.01).FEV1%predicted of three groups were (50.60±19.98)%、(60.10±25.32)%、(94.19±19.71)%，The acute phase compared with the control group, the stationary phase andcontrol group difference was statistically significant (P <0.01). Plasma NGAL level ofthe acute phase group was positive correlation with plasma neutrophil counts、hs-CRP(0.352,<0.01;0.384,<0.01),and was negative correlation with arterial oxygenpartial pressure, FEV1%predicted, FVC%predicted(-0.285,0.03;-0.269,0.04;-0.303,0.02). Plasma NGAL level of the stationary phase group was positive correlationwith plasma neutrophil counts、 hs-CRP、 FEV1%predicted、 FVC%predicted(0.463,<0.01;0.484,<0.01;0.389,0.03;0.369,0.04),and was negativecorrelation with Arterial oxygen tension(-0.409,0.02). The total number of inducedsputum cell counts of three groups were (68.2±15.1)%,(57.2±11.9)%,(35.2±8.5)%，the difference among the three groups was statistically significant(P<0.05).Sputumneutrophils accounted for a percentage of total cells of the three groups were (68.2±15.1)%,(57.2±11.9)%,(35.2±8.5)%，the difference among the three groups wasstatistically significant (P <0.05).Percentage of sputum macrophages of three groupswere (13.3±7.6)%,(21.8±7.1)%,(39.5±10.0)%，the difference among the threegroups was statistically significant (P <0.05). NGAL levels in sputum supernatants ofthe three groups were (16.6±5.4)mg/L，(3.0±0.6)mg/L，(0.7±0.3)mg/L，the difference among the three groups was statistically significant (P <0.05). Sputum NGAL level ofthe acute phase group was positive correlation with sputum neutrophilpercentage(0.352,0.004)，and was negative correlation with arterial oxygen partialpressure, FEV1%predicted,FVC%predicted(-0.348,0.01;-0.300,0.03,-0.284,0.04).Sputum NGAL level of the stationary phase group was positive correlationwith sputum neutrophil percentage(0.499,0.005),and negative correlation with arterialoxygen partial pressure, FEV1%predicted,FVC%predicted(-0.513,0.04;-0.423,0.02;-0.402,0.03).Conclusion Plasma NGAL levels and induced sputum NGAL levels of patients withacute exacerbation of chronic obstructive pulmonary disease were significantlyincreased, and were associated with lung function, arterial oxygen tension and otherindicators. Plasma NGAL might be a useful new marker for evaluating AECOPD.