C-reactive protein in patients with COPD, control smokers and non-smokers
C-reactive protein in patients with COPD, control smokers and non-smokers
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DOI：
10.1136/thx.2005.042200
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发表时间：
2006-01-01
期刊：
影响因子：
10
通讯作者：
Celli, BR
中科院分区：
文献类型：
--
作者：
Pinto-Plata, VM;Müllerova, H;Celli, BR
背景：慢性阻塞性肺疾病（COPD）患者血清C反应蛋白（CRP）水平升高。这可能与COPD及其相关的全身性炎症直接相关，或继发于其他因素，如伴随的缺血性心脏病（IHD）或吸烟状态。本研究的目的是评估IHD和吸烟的潜在原因，提高CRP水平在COPD和测试之间的关联吸入性皮质类固醇（ICS）的使用和血清CRP level.Methods：横断面分析比较队列的88例COPD患者，33吸烟者（S），和38非吸烟者（NS）的控制进行。临床评估包括完整的病史、肺功能、6分钟步行试验（6 MWT）、心肺运动试验和高灵敏度血清CRP测定。（5.03（1.51）mg/l）（校正比值比9.51; 95%置信区间2.97至30.45），但两个对照组相似（S：2.02（1.04）mg/l; NS：2.24（1.04）mg/l）。在任何受试者中均无不稳定IHD的临床或运动证据。ICS治疗的COPD患者的CRP水平低于未治疗的患者（3.7（3.0）mg/l vs 6.3（3.6）mg/l）;在校正回归模型中证实了这种关联（p< 0.05）。结论：CRP水平在无临床相关IHD的COPD患者中升高且与吸烟无关，而在使用ICS的COPD患者中降低。CRP可能是COPD患者发生炎症过程的全身标志物。
Background: Patients with chronic obstructive pulmonary disease ( COPD) have raised serum levels of C reactive protein (CRP). This may be related directly to COPD and its associated systemic inflammation or secondary to other factors such as concomitant ischaemic heart disease (IHD) or smoking status. The aim of this study was to evaluate IHD and smoking as potential causes of raised CRP levels in COPD and to test the association between inhaled corticosteroid (ICS) use and serum CRP levels.Methods: Cross sectional analyses comparing cohorts of 88 patients with COPD, 33 smokers ( S), and 38 non-smoker (NS) controls were performed. Clinical assessments included a complete medical history, pulmonary function, 6 minute walk test (6MWT), cardiopulmonary exercise test, and high sensitivity serum CRP measurements.Results: Serum CRP levels were significantly higher in patients with COPD (5.03 (1.51) mg/l) than in controls ( adjusted odds ratio 9.51; 95% confidence interval 2.97 to 30.45) but were similar in the two control groups (S: 2.02 (1.04) mg/l; NS: 2.24 (1.04) mg/l). There was no clinical or exercise evidence of unstable IHD in any of the subjects. CRP levels were lower in COPD patients treated with ICS than in those not treated (3.7 (3.0) mg/l v 6.3 (3.6) mg/l); this association was confirmed in an adjusted regression model (p< 0.05).Conclusion: CRP levels are raised in COPD patients without clinically relevant IHD and independent of cigarette smoking, and reduced in patients with COPD using ICS. CRP may be a systemic marker of the inflammatory process that occurs in patients with COPD.