The Clinical Value Of Serum Hs-CRP For The Acute Exacerbation Bronchial Asthma Patients

Objective: We studied the correlation between the level of serum hs-CRP andinduced sputum cell counts, and the associations of the above inflammation index withthe lung function and asthma control test in order to investigate the clinical applicationvalue of serum hs-CRP for the acute exacerbation bronchial asthma patients.Methods:30acute exacerbation bronchial asthma inpatients in the respirationdepartment of the second hospital of dalian medical university from september todecember in2011were collected as the asthma group,and the control group came fromhealthy people who went to hospital for medical examination during the same period.The control group had denied lung disease history and smoking history; the diagnosisand stratification standard of acute exacerbation asthma was referenced to guide forcough published in2009.During the induction period,PEF was monitored, we stoppedthe induction and provided the asthma patients with salbutamol inhalation once the PEFdescended by more than20%compared with the PEF before induction. We collectedthe induced sputum and serum from the control group and from the asthma group beforeand after treatment (methylprednisolone40-80mg/d)respectively, in order to getleukocyte classification counts such as EOS%、N%、M%、L%by a microscope and toget the serum level of serum hs-CRP. At the same time, we selected the pulmonaryfunction index such as FEV1pred%, FEV1/FVC%, MMEFpred%from both of thegroups and the ACT scores of the asthma inpatients to explore whether serum hs-CRPhad relevance to the above-mentioned index.Results: The induction success rate of the44study objects was95.45%, astwo asthma patients were failed in induction. The serum hs-CRP level in asthmagroup was significantly higher than those of the control group [4.18(11.12,2.12) mg/Lvs1.48(4.81,1.03)mg/L, P=0.000]. In asthma group, the level of serum hs-CRP after treatment was lower than those of before treatment [3.40(8.91,2.02)mg/L vs1.48(4.81,1.03)mg/L,P=0.006].In asthma groups, serum hs-CRP had positiverelationship with induced sputum EOS%(r=0.849,P=0.000).There were negativecorrelations between serum hs-CRP and pulmonary function index such as FEV1pred%,FEV1/FVC%,MMEFpred%(r=-0.617,-0.559,-0.398,respectively， P=0.000,0.002,0.036,respectively). It was also found that the level of serum hs-CRP and ACT scores had theremarkable Spearman ’s linear correlation (r=-0.511, P=0.005). The AUC value ofserum hs-CRP for ROC curve was0.713（P=0.003）,When serum hs-CRP was equal to3.65mg/L, the sensitivity degree was0.643and the specific degrees was0.667foridentifing asthma group from the control group. The AUC of serum hs-CRP value wasslightly lower than those of induced sputum EOS%(0.713vs0.794).Conclusion:There were significantly correlations between serum hs-CRP andinduced sputum eosinophils granulocyte count, pulmonary function, ACT score in theacute exacerbation bronchial asthma inpatients,It was found that hs-CRP could beconsidered as one of the potential marker used to evaluate the systemic inflammationlevel of bronchial asthma.