| OBJECTIVE Through examining the cortisol(COR) levels in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) comparing the differences of COR levels in different groups of patients with AECOPD, and probing into the relationship between COR levels in the blood of patients with some factors as C-protein (CRP), and arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), age and the duration of chronic obstructive pulmonary disease illness, to investigate the functional status of adrenal cortex in patients with AECOPD.METHODS From January 2014 to December 2014,94 AECOPD hospitalized patients were selected at the Sixth Affiliated Hospital of Guangxi Medical University, Department of Respiratory Medicine as samples of this study, and they are divided into different groups according to GOLD 2011 version of recommendations for assessment of the patient condition. Samples with endocrine diseases as well as those with long-term usage of glucocorticoid therapy are excluded. All patients had all the CRP, PaO2, PaCO2 tests on the first day they were hospitalized, and were extracted from peripheral blood 2-4ml at 8:00 (8AM),16:00 (4PM) and night 0:00 (0AM) respectively the next day for quantitative detection of plasma COR levels in the laboratory.RESULTS In this study, there were 94 cases of AECOPD patients, with 72 male cases and 22 female cases, and were divided into four groups, namely, A, B, C, and D, according to the evaluation method of the GOLD2011 version of the disease. With 13 cases in group A,16 cases in group B,27 cases in group C, 38 cases in group D. there was no Statistic difference on the average age among the four groups. Compare with normal standard,24 cases increased,64 cases maintained normal, and 6 cases decreased the level of blood COR AECOPD in patients with 8AM,44 cases increased 44 cases maintained normal,6 cases decreased with 4PM; With 0AM level,41 cases increased,46 cases were normal, 7 cases decreased. The average level of 0AM is higher than the upper limit of the normal value, and the means of 8AM 4PM COR were in the normal range. The serum levels of COR with most AECOPD patients were not decreased, while part of them were increased. According to the diagnostic criteria of COR circadian rhythm disorder, COR levels of 94 cases of AECOPD patients were measured at three testing time,93 cases were found in 94cases of COR secretion rhythm disorder.There were no statistically significant differences among AECOPD A, B, C, D four groups of COR levels (P> 0.05). Pearson correlation analysis showed that, The correlation of plasma COR and plasma inflammatory index C-reactive protein (CRP) in AECOPD patients is as follows:the correlation between CRP positive correlation (r=0.221, P=0.032< 0.05); no significant correlation between 4PM COR and CRP (r=0.131, P=0.207); no significant correlation between 0AM and COR (CRP r=0.193, P=0.062). Relationship between COR and arterial oxygen partial pressure (PaO2) in vivo: no significant correlation between 8AM COR and PaO2 (r=-0.169, P=0.104); 4PM COR was negatively correlated with PaO2 (r=-0.260, P=0.011< 0.05); 0AM COR was negatively correlated with PaO2 (r=-0.225, P=0.029< 0.05). Relationship between COR and arterial carbon dioxide partial pressure (PaCO2) in vivo:8AM COR was positively correlated with PaCO2 (r=0.358, P=0.000< 0.05); 4PM COR was positive correlation with PaCO2 (r=0.405, P=0.000< 0.05); 0AM COR was positive correlation with PaCO2 (r=0.225, P=0.029< 0.05). The correlation of COR with age, the length of the disease was not related, and the P values of each point were greater than 0.05.CONCLUSIONS 1.The functional disorder of adrenal cortex secretion was present in AECOPD patients, and the serum levels of COR of most patients were not decreased, and some even were increased.2.The level of COR in patients with AECOPD was not significantly related to the severity of the disease.3.There is a negative correlation with COR and PaO2 levels in patients with AECOPD, and positively correlated with PaCO2 level, and there maybe a positive correlation with serum CRP.4.The level of COR in AECOPD patients with age, the duration of the disease showed no correlation. |
PDF Full Text Request