Effect of inflammatory biomarkers on death of patients with chronic obstructive pulmonary disease / 中国综合临床

ABSTRACT

Objective To investigate the clinical significance of related inflammatory biomarkers on chronic obstructive pulmonary disease (COPD) associated mortality,in order to provide the basis for clinical screening of high risk patients.Methods One thousand five hundred cases of outpatients and inpatients from Feb.2012 to Mar.2013 were selected as our subjects.All patients were conducted 15-27 months followup.According to patient outcome,they were divided into survival(1346 cases) and death groups (154 cases).The clinical data,pulmonary function,level of respiratory difficulty and inflammatory biomarker levels were recorded.Results The average age of the death group was (65.3 ± 12.2) years old,significantly higher than that of the survival group ((60.2 ± 11.5) years old,and the difference was significant (t =5.180,P ＜ 0.01).Body mass index(BMI) in death group was (19.8 ±5.4) kg/m2,significantly lower than that of the survival group(23.2 ± 5.6) kg/m2 and the difference was significant (t =7.373,P ＜ 0.01).There was no statistical difference between the two groups in terms of gender (P ＞ 0.05).The levels of 1 s forced expiratory volume (FEV1),FEV1/forced vital capacity (FVC),the British Medical Research Council dyspnea scale (MMRC) rating in death group were (1.1 ± 0.4) L,(40.8 ± 8.2) ％ and (2.8 ± 1.3),significantly lower than those of the survival group((1.5 ±0.5) L,(46.3 ± 11.2) ％,(2.1 ± 1.2))..FEV1 and FEV1/FVC of death group were significantly lower than those of the survival group,while the MMRC significantly higher,and the differences were significant (t =9.582,5.914,6.797,P ＜ 0.01).The levels of C-reactive protein(CRP),interleukin-6(IL-6),IL-8,tumor necrosis factor-α (TNF-α),neutrophil levels in death group were (4.8 ± 1.2)mg/L,(154.4 ± 28.6) ng/L,(398.8 ± 86.3) ng/L,(942.6 ± 212.8) ng/L,(6.0 ± 2.8) × 109/L,significantly higher than those of the survival group ((3.4 ± 1.1) mg/L,(112.8 ±23.6) ng/L,(332.7 ± 76.3) ng/L,(1 482.8 ± 223.6) ng/L,(5.1 ± 1.5) × 109/L),and the differences were statistically significant (t =14.818,20.242,10.041,29.684,6.299,P＜0.01).Conclusion Inflammatory biomarkers including CRP,IL-6,IL-8,TNF-α and neutrophils are the risk factors of death in patients with COPD.Then clinical attention should be paid to the patients with inflammatory biomarkers for monitoring physical level,in order to guide the clinical screening for high-risk cases,timely take corresponding measures and improve the prognosis.