The Clinical Significance In Detecting SVCAM-1in Patients With Chronic Objective Pulmonary Disease

Objective:This paper begins with investigation in the levels of prothrombotic statemedia,such as sVCAM-1, D-dimer, Fbg, PLT, and systemic inflammation markershs-CRP in patients with COPD,followed by exploring the relationship and influence onprothrombotic state and systemic inflammation response in the acute exacerbation andstable COPD patients.Then this paper analyzes the relationship between sVCAM-1andthe severity of COPD and gives a discussion on whether sVCAM-1can be used as theeffective index of the inflammatory response in the patients with COPD, whether it canbe used as evaluation index of PTS and its severity.and effective index of the diseaseseverity and prognosis in the patients with COPD.The paper provides a new theoreticalfoundation about the treatment of CCP even concurrent PTE,which the development ofCOPD may turn to.Methods:We collected clinical data in30patients with COPD and30healthypeople as controls.Patients were estimated by the GOLD of2011.According to thepatients’ symptoms,lung function and acute exacerbation history in last year.We divideddisease severity into A, B, C, D four grades.sVCAM-1level was detected by the methodof double antibody sandwich enzyme-linked immunosorbent assay (ELISA),and at thesame time we tested the serum of AECOPD patients.Patients were given relevanttreatments according to patients condition.Peripheral blood sample were collectedwithin24h, to measure serum levels of indicators such as sVCAM-1,D-dimer,Fbg andPLT on the COPD patients,and serum levels of sVCAM-1, D-dimer aftertreatment.SPSS19.0statistical software process was used to evaluate the relationship among sVCAM-1,hs-CRP, D-dimer, Fbg, PLT and the correlation of disease severity.P<0.05was statistically significant.Results:1.There was a positive correlation between the serum level of sVCAM-1andhs-CRP inAECOPD patients(r=0.597,P <0.05);2.The serum level of sVCAM-1was significantly higher in patients withAECOPD[(44.357±13.232)ng/ml]than that in patients with SCOPD[(38.505±16.192)ng/ml](P<0.05), and both of them were higher than that in the controlgroup[(31.415±9.502)ng/ml](P<0.05),the differences were statistically significant.Therewas a positive correlation between the level of sVCAM-1and D-dimer in AECOPDpatients(r=0.533, P<0.05);while the level of sVCAM-1in patients with SCOPD waspositively correlated with D-dimer level(r=0.584, P<0.05);There was a positivecorrelation between the level of sVCAM-1and Fbg in AECOPD patients(r=0.409,P<0.05);There was no correlation between the level of sVCAM-1and PLT in AECOPDpatients (r=0.288, P>0.05);As prothrombotic state media,the area under the ROC curveof sVCAM-1was0.791,95%confidence interval was from0.677to0.905(P<0.01);Thearea under the ROC curve of D-dimer is0.784,95%confidence interval was from0.663to0.906(P <0.01);The area under the ROC curve of Fbg was0.679,95%confidenceinterval was from0.559to0.838(P <0.01).The biggest one was that area under theROC curve of sVCAM-1.3. The serum of sVCAM-1and the severity of COPD exist positive correlation(rs=0.606,P<0.05).Conclusion:1.The serum of sVCAM-1,as biomarkers of inflammation response,may have acertain clinical reference value for the diagnosis of patients with COPD.2.The serum of sVCAM-1may be expected as the index to judge patients withCOPD complicated with PTS and the severity of PTS,and perhaps could beexpected as a reference index to judge the illness and the effect of treatment andprognosis in patients with COPD. 3. sVCAM-1and the severity of COPD may exist positive correlation and theevaluation of patients with the severity of COPD can be detected by sVCAM-1.