Serum Levels Of MR-proADM And Hs-CRP In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease Under Different Grading Of BODE Index

Objective:To investigate the changes and significance of serum Mid-regional pro-adrenomedullin（MR-proADM）and Hypersensitive C-reactive protein（hs-CRP）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）in different BODE index groups;To explore the changes in serum MR-proADM levels of COPD patients in each BODE index group in the acute exacerbation phase and the stable phase;Analyze the correlation between MR-proADM and lung function FEV1%pred,6-minute walk test,modified British Medical Research Council respiratory questionnaire（m MRC）,body mass index（BMI）,and high-sensitivity C-reactive protein.Methods:A collection of 127 patients who met the diagnostic criteria for COPD at the Fourth Affiliated Hospital of Inner Mongolia Medical University from December 2019 to December 2020 were collected as the experimental group,and 30 healthy people who came to our hospital for physical examination were selected as the control group.Measure the serum MR-proADM and hs-CRP contents of the experimental group and the control group,the percentage of forced expiratory volume in the first second to the predicted value（FEV1%pred）,and BMI;measure the six-minute walking distance（6MWD）of the experimental group to evaluate Its m MRC index;according to the BODE index scoring standard,the experimental group of AECOPD patients included in the study were divided into four groups（BODE index level 1 group,BODE index level 2 group,BODE index level 3 group and BODE index level 4 group）;for each BODE AECOPD patients in the index group were followed up to determine the serum MR-proADM content during the stable period.Results:（1）The serum MR-proADM level of each experimental group was higher than that of the control group（P<0.05）,the BODE index level 4 group was higher than the other 3 BODE index groups（P<0.05）,the BODE index level 3 group was higher than the BODE index 2 Grade group,BODE index grade 1 group（P<0.05）,There was no significant difference between the BODE index level 2 group and the BODE index level 1 group（P>0.05）;The serum hs-CRP levels of each experimental group were higher than those of the control group（P<0.05）.The serum hs-CRP levels among the groups were grade4 group,grade 3 group,grade 2 group and grade 1 group in descending order.The differences between the groups were statistically significant（P<0.05）.During the acute exacerbation of COPD patients in each BODE index group,the serum MR-proADM level was higher than its stable period（P<0.05）.（2）There was a positive correlation between serum MR-proADM and hs-CRP and m MRC in the experimental group（r values were 0.645 and 0.651,P<0.05）,and the serum MR-proADM in the experimental group was negatively correlated with FEV₁%pred and 6MWD（r values were respectively-0.484,-0.788,P<0.05）;there is no correlation between serum MR-proADM and BMI in the experimental group（P>0.05）,and there is no correlation between serum MR-proADM and hs-CRP,FEV1%pred,and BMI in the control group（P>0.05）.Conclusion:（1）The levels of serum MR-proADM and hs-CRP in AECOPD patients are different from those of healthy people.The levels of MR-proADM and hs-CRP in AECOPD patients increase as the patient’s condition worsens.（2）The level of MR-proADM in the acute exacerbation phase of COPD patients is higher than the level in the stable phase,suggesting that it may have a reference value in the monitoring of changes in the condition of COPD patients.（3）The MR-proADM level of AECOPD patients is positively correlated with the m MRC value,and negatively correlated with the6MWD value and FEV₁%pred value,suggesting that it can reflect the exercise capacity,airway obstruction degree and dyspnea degree of AECOPD patients to a certain extent.（4）There is a positive correlation between MR-proADM and hs-CRP in AECOPD patients,and the combined detection of MR-proADM and hs-CRP levels may improve the efficiency of disease detection.