Clinical Value Of Serum C-Reaction Protein,prealbumin And Cystatin C In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: To detective the changes of serum C-Reaction Protein,Prealbumin and Cystatin C and their clinical significance of determination in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),so that the combination of the three markers may provide a certain theoretical basis for clinical observation of AECOPD.Methods: In total of 77 AECOPD patients were recruited into the study since January 2014 to December 2015,whom hospitalized in the department of respiratory medicine,the First Affiliated Hospital of Wannan Medical College.Gave standard treatment after admission and divided into improvement group and unimprovement group according to the outcome.To detect the serum C-reaction protein,prealbumin and cystatin C concentration on the first day of admission and before discharge;or after standard treatment for 2 weeks when the condition has not been improved.To obtain all the patiets' CAT score and the recent lung function data.In the same period,60 healthy adults recruited to detcte the serum C-reaction protein,prealbumin and cystatin C concentration,too.All peripheral blood samples were collected,measured,determined according to standard procedure by professionals.All the datas were analyzed with SPSS 18.0 software.Results: 1.All the general information(such as age,sex composition ratio,smoking status,body mass index,etc.)had no statistical significance(P>0.05),there was comparability among the groups.2.The serum Cys-C,CRP levels in the improvement group were(1.55±0.48;32.05±20.45)mg /l before treatment and(1.25±0.34;8.60±6.79)mg /l after treatment respectively,and higher than that of control group(0.92±0.15;4.07±2.43 mg /l).The level of serum PA in improvement group was(148.48±52.67)mg /l before treatment and(186.53±47.41)mg/l after treatment,both were lower than that of control group(214.78 ±72.87)mg/l.The serum CRP,Cys-C levels were significantly lower in improvement group after treatment;and the serum PA level was significantly higher after treatment.All the differences were statistically significant(P < 0.05).The changes of serum CRP,PA,Cys-C levels in the unimprovement group is opposite.3.In patients of AECOPD,there was no correlation between serum CRP,PA,Cys-C levels and FEV1% pred,FVC(P > 0.05);but there was low correlation between serum CRP,PA,Cys-C levels and CAT scores.4.There is a significant correlation respectively between the change of serum CRP,PA,Cys-C and the CAT score changes in patients with AECOPD after treatment(P < 0.05).5.There was a negative correlation between pred FEV1%pred and CAT score in the observation group(r =-0.47;P < 0.01);but there was no correlation between pred FVC and CAT score(r =-0.24;P = 0.06).Conclusion: 1.The application of serum CRP,PA or Cys-C alone can not reflect the severity of the disease and the quality of life of patients very well.2.CAT score may reflect the degree of airflow limitation and severity of disease in patients to a certain extent.3.Monitoring the changes in the concentration of serum CRP,Cys-C,PA dynamically is helpful to evaluate the conditions and prognosis.And the combined detection of CRP,PA and Cys-C concentration in serum may provide some certain theoretical basis for the observation of AECOPD.