Evaluation Of Exhaled Nitric Oxide And Serum High-sensitivity C-reactive Protein In Chronic Obstructive Pulmonary Disease With Acute Exacerbation

Objective:To analyze high sensitivity C-reactive protein (Hs-CRP) and exhalednitric oxide (FeNO) in patients with chronic obstructive pulmonary disease inacute exacerbation period (AECOPD) in this article, and explore therelationship between the variation of HS-CRP and clinical significance inpatients suffering from AECOPD.Methods:Regard60patients hospitalized AECOPD in the First Hospital of JilinUniversity of Respiratory Medicine as AECOPD group from September2012to June2013. These patients were conducted corticosteroids treatments,anti-inflammatory, cough, phlegm, and symptomatic treatments. After acuteonset of symptoms and signs was improved as COPD remission. at the sametime, selecting20healthy volunteers who do not smoke as the healthy controlgroup. Do the measurements of exhaled nitric oxide (FeNO) concentration,high-sensitivity C-reactive protein (CRP) and pulmonary function. Accordingto the patients’ symptoms to determine the extent of abnormal lung functionclassification,10patients I (mild),22cases of II (moderate) patients, III (severe)16patients, IV (very severe)12patients. Using statistical methodsto understand the statistical significance of the detection method above inthe evaluation of chronic obstructive pulmonary disease with acuteexacerbation.Results:(1) Each group of FeNO value、Hs-CRP levels and FEV1%predicted:FeNO value, Hs-CRP, FEV1%predicted levels in AECOPD group are:(27.49±11.54)ppb,(37.87±25.62,)mg/L,(49.23±17.64)%. The levels ofFeNO value, Hs-CRP, FEV1%predicted in the COPD group of stable periodare (21.28±4.53)ppb,(11.80±6.48) mg/L，(57.85±19.36)%.The levels of FeNO value, Hs-CRP, FEV1%predicted in the the healthycontrol group are (17.58±4.03)ppb,(1.52±0.82) mg/L.(2) COPD remission group and AECOPD group, FeNO values decreased,the difference is statistically significant (P <0.01). AECOPD group and COPDremission and healthy control group difference is statistically significant (P<0.01).(3) Serum CRP levels in patients with AECOPD is higher than the COPDremission group and the healthy control group, the difference is statisticallysignificant (P <0.01), HS-CRP levels of COPD remission group is above thehealthy control group, the difference is statistically significant (P <0.01).(4) There is a negative correlation between in AECOPD group serumHS-CRP levels and forced expiratory volume in one second (forced expiratory volume in one second, FEV1) percentage of predicted value. before treatmentin AECOPD patients,there is no significant correlation between FEV1%predicted and FeNO value (r=0.097, P>0.05),there is positive correlationbetween FeNO value before treatment and FEV1%after treatment inAECOPD group (r=0.658P<0.05). There is a positive correlation betweenelevation with FEV1%after treatment and declination in the value ofFeNO(r=0.672, P <0.05).Conclusion1. FeNO method is a simple, feasible, noninvasive, repeatable and strictquality control methodology. AECOPD patients’ FeNO level will decreaseafter treatment, higher than the healthy group, which suggests that FeNO canbe used to diagnose airway inflammation in AECOPD patients.2. Serum CRP in healthy human body is in low level while it will be in highlever for COPD patients. So the CRP is closely related to the Airwayinflammation. of COPD.3. Compared with remission of COPD and healthy controlled group, theFeNO level and Hs-CRP concentration of serum for AECOPD patients arehigher. Similarly, the FeNO level and Hs-CRP concentration of serum forheavy and extremely heavy AECOPD patients are higher than in mild tomoderate AECOPD group. The Hs-CRP concentration of serum has a negativecorrelation with the percentage of FEV1, indicating that serum CRP is one ofthe potential standard to reflect the severity of AECOPD. 4. Not only there is a positive correlation between FeNO level beforetreatment and the increment of FEV1%after treatment, but after treatment,there is also positive correlation between the decrease of FeNO and increaseof FEV1%. It suggests that FeNO is an effective parameter to predict thereaction of the patients during the treatment.