Clinical Significance Of α1-AT And CRP Detection In Patients With Chronic Obstructive Pulmonary Diseases

BackgroundChronic obstructive pulmonary diseases (COPD) is a major chronic respiratory disease, pathogenesis of COPD is not completely clear now. Forced expiratory volume1second (FEV1%) is commonly used indicators of respiratory function evaluation. While in recent years, many scholars have pointed out that the existence of the problem of inadequate diagnostic criteria, al-antitrypsin (al-AT) is the most important plasma protease inhibitor, C-reactive protein (CRP) is a non-specific tissue damage response protein. In this study, al-AT and CRP level in patients with acute exacerbation of COPD were tested to explore the clinical significance of al-AT and CRP in diagnosis and treatment of COPD.Objective1. To investigate serum C reactive protein (CRP) and alphal-antitrypsin (al-AT) levels in patients with chronic obstructive pulmonary disease (COPD) and the correlation with the severity of COPD.2. To observe the clinical effect of inhaled glucocorticosteroid (ICS) in treatment of acute exacerbation chronic obstructive pulmonary disease (AECOPD) and the change of al-AT and CRP levels.Methods1.140patients with COPD in our hospital from May the year2012to May the year2013were chosen and divided randomly to64patients with AECOPD group and76patients with stable COPD group.60healthy subjects were also chosen to be as the normal control. The al-AT and CRP levels of three groups were determined and compared, and the correlations with COPD were analyzed. 2.64patients with AECOPD were divided randomly to observation group and control group, which all treated by basis treatment and pulverization inhalation treatment with salbutamol and ipratropium bromide. Patients in observation group were also given pulverization inhalation treatment of budesonide. The percentage of forced expiratory volume in1second to prediction value (FEVi%), the percentage of forced expiratory volume in1second to forced vital capacity (FEV1/FVC%), arterial partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), dyspnea grade score, levels of serum CRP and α1-AT were compared after seven days treatment, and the clinical effects were evaluated and compared.Results1. The levels of serum CRP and al-AT in COPD groups were significantly higher than those in normal control (P<0.05). The CRP level in AECOPD group were significantly higher than that in stable COPD group (P<0.05), but the al-AT level have no obviously differences between AECOPD group and stable COPD group (P>0.05). In COPD groups, CRP level had no obviously correlation with al-AT level (P>0.05), while it had negative correlation with FEV1%and FEVi/FVC%(P<0.05); the al-AT level had no obviously correlation with FEV1%and FEVi/FVC%(P>0.05).2. The values of FEVi%, FEVi/FVC%, PaO2, PaCO2, and dyspnea grade score were apparently improved after treatment in both groups (P<0.05), and the improvement degrees in observation group were more obviously than those in control group (P<0.05). The total therapeutic effective rate of observation group was93.75%, significantly higher than that of control group (84.37%). The levels of serum CRP and al-AT were significantly decreased after treatment, and the CRP level was significantly lower in observation group than that in control group (P<0.05), while the al-AT level in two groups had no statistically significant differences (P>0.05).ConclusionCRP is a sensitive indicator for the patients with COPD, combined with al-AT associated detection, have clinical practical value for diagnose and therapeutic effect judging in COPD.