Effects Of Stress Hormones On The Risk Of Actue Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective:1.The aim of our study was to investigate whether there is stress of exacerbation of chronic obstructive pulmonary disease(COPD)patients.2.To observe the relationship between different hormone levels and symptoms,severity of illness,prognosis and the quality of life after patients discharged on COPD patients.Design:prospective study method.Methods: patients who met the criteria of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),were enrolled in the department of Geriatric Respiratory Medicine of the First Affiliated Hospital of Guangxi Medical University: 1.Respectively assess the condition of patients by the comprehensive evaluation system of COPD issued in 2013 COPD global initiative,through the assessment of symptoms and pulmonary function evaluation,risk assessment of acute exacerbation were divided into A,B,C,Dfour groups.2.Using the BODE prognostic index,including the body mass idex(BMI),airflow limitation,the dyspnea score,and exercise tolerance,to evaluate the prognosis of patients.3.The concentrations of cortisol,ACTH,renin,angiotensin II in peripheral blood were measured by radio immunoassay(RIA).4.The patients werefollowed up for six months after discharge,including telephone follow-up,outpatient and inpatient follow-up.Results:1.The serum renin,angiotensin II concentrations in patients with exacerbation of COPD were significantly increased(P<0.05),while the serum cortisol and ACTH concentrations lower than the control group(P>0.05).2.In the stress groups,the serum cortisol concentrations were significantly increased(P < 0.05),and the patients showed more physical symptoms and longer hospitalization days(P>0.05).After 6 months of follow-up,the number of patients with recurrent acute exacerbation was more than that in the non stress group(P<0.01),and poor symptom relief(P<0.05).Conlusion:1.There are different degrees of stress in patients with acute exacerbation of COPD.2.The stress characteristics of elderly patients with AECOPD show incomplete stress,that is,the levels of serum renin and Ang?are increased,while the levels of ACTH and cortisol are not obvious.3.Compared with patients without stress,stress increase the risk of AECOPD within 6 mouths after discharge.