PDF(Pubmed)
Abstract：
Background/Objective: Systemic inflammation is common in chronic obstructive pulmonary disease (COPD), and evidence suggests that inflammatory biomarkers can predict acute exacerbations (AECOPDs). The aim of this study was to analyse whether C-reactive protein (CRP), fibrinogen, white blood cell count (WBC), or the blood cell indices PLR (platelet-to-lymphocyte ratio), SII (systemic immune inflammation index), SIRI (systemic inflammation response index), and AISI (aggregate index of systemic inflammation) can predict future AECOPDs. Methods: In the Tools Identifying Exacerbations (TIE) cohort study, participants with spirometry-confirmed COPD were recruited from primary and secondary care in three Swedish regions and assessed during a stable phase of COPD. AECOPD frequency during the three-year follow-up was reviewed in medical records. Associations were analysed via ordinal logistic regressions. Results: Of the 571 participants, 46% had ≥1 AECOPD during follow-up, and the mean ± SD AECOPD frequency was 0.63 ± 1.2/year. In unadjusted analyses, high levels of CRP (odds ratio 1.86, 95% CI 1.29-2.67), fibrinogen (2.09, 1.38-3.16), WBCs (2.18, 1.52-3.13), SII (1.52, 1.05-2.19), SIRI (1.76, 1.23-2.52), and AISI (1.99, 1.38-2.87) were associated with a higher AECOPD frequency. After adjustment for AECOPD history, age, sex, smoking, body mass index, COPD Assessment Test score, lung function, and inhaled corticosteroid use, associations remained for high levels of CRP (adjusted odds ratio of 1.64; 95% CI of 1.08-2.49), fibrinogen (1.55; 1.07-2.24), and WBC (1.65; 1.10-2.47). Conclusions: CRP, fibrinogen, and WBC, assessed during stable-phase COPD, enhanced AECOPD prediction, whereas PLR, SII, SIRI, and AISI did not.
摘要：
背景/目的:全身炎症在慢性阻塞性肺疾病(COPD)中很常见,证据表明,炎症生物标志物可以预测急性加重(AECOPD)。这项研究的目的是分析是否C反应蛋白（CRP），纤维蛋白原，白细胞计数(WBC),或血细胞指数PLR（血小板与淋巴细胞之比），SII（全身免疫炎症指数），SIRI（全身炎症反应指数），和AISI（全身炎症综合指数）可以预测未来的AECOPD。方法：在工具识别急性加重(TIE)队列研究中，我们从瑞典三个地区的一级和二级医疗机构招募肺活量测定证实为COPD的参与者,并在COPD稳定期进行评估.在3年随访期间的AECOPD频率在病历中进行了回顾。通过序数逻辑回归分析关联。结果：在571名参与者中，46%的患者在随访期间出现≥1次AECOPD,平均±SDAECOPD频率为0.63±1.2/年。在未经调整的分析中，高水平的CRP（比值比1.86，95%CI1.29-2.67），纤维蛋白原（2.09，1.38-3.16），WBC(2.18,1.52-3.13),SII(1.52,1.05-2.19),SIRI（1.76，1.23-2.52），AISI（1.99，1.38-2.87）与较高的AECOPD频率相关。调整AECOPD历史后，年龄,性别,吸烟,身体质量指数,COPD评估测试评分,肺功能,吸入皮质类固醇的使用，高水平的CRP仍然存在关联（调整后的比值比为1.64；95%CI为1.08-2.49），纤维蛋白原（1.55;1.07-2.24），和白细胞（1.65;1.10-2.47）。结论:CRP,纤维蛋白原，WBC,在稳定期COPD期间评估，增强AECOPD预测，而PLR,SII,SIRI,而AISI没有.
