Study On The Relationship Between CRP, PCT, FIB And D - Dimer In Acute Exacerbation Of COPD

Chronic Obstruct ive Pulmonary Disease(COPD) is a type of chronic progressive respiratory diseases characterized by chronic obstructive airflow associated with the aggregation of chronic inflammation reaction on airway and lung tissues commonly caused by harmful fumes and particles. The lesions have various complications:they will mainly harm the lung, but they may also cause adverse effects to other organs in human’ s body. In recent years, the incidence rate as well as the mortality rate of COPD tended to increase year by year. Now COPD has been the 4th top cause of death globally. It is estimated that by the year of 2020, COPD would leap to the 5th place of the global economic burden of disease and become a serious public health issue. Acute Exacerbation Chronic Obstructive Pulmonary Disease (AECOPD) is an acute onset progress which represents acute worsening of respiratory system in a patient with underlying COPD. Repeated outbreak may accelerate the progression of COPD and pose threat to the patient’ s life. The present diagnoses on AECOPD still entirely rely on clinical manifestation. So far the medical field has not exactly discovered any biomarker which could be applied to COPD/AECOPD’s clinical diagnosis and treatment.Traditional Chinese Medicine(TCM) used to lack of clear disclosure on COPD or AECOPD. In most cases TCM would simply treated them as "gasp syndrome" or "lung-distens ion". In recent years the TCM field has developed growingly mature understandings on the etiology and pathogenesis of COPD and AECOPD. The relationship between syndrome of TCM and physicochemical indexes of western medicine as well as the division of the standard of TCM’s syndrome differentiation has become a hotspot in clinical researches.Purposes:This research adopts the method of retrospective study. For the past three years,62 AECOPD patient cases with syndrome of phlegm-heat obstructing lung were selected and collected in the Beijing University of Chinese Medicine Dongfang Hospital. Aiming at providing objective reference for the establishment, development and prognosis of TCM disease syndrome and building the bridge for communication between TCM and Western medicine regarding the same disease, by analyzing AECOPD patients’blood level of CRP, PCT, FIB, D-Dimer, this research looked into the relationship between elements & pathogenesis characteristics of AECOPD with syndrome of phlegm-heat obstructing lung and the physicochemical indexes of western medicine.The research result shows that:the AECOPD with syndrome of phlegm-heat obstruct ing lung patients’CRP, PCT, FIB and D-Dimer levels are higher than their post-treatment levels, the results have statistical significance (P<0.05); there are positive correlations between the patients’post-treatment CRP,PCT and D-Dimer levels and prognosis (r>0), the results have statistical significance (P<0.05); the patients’post-treatment FIB levels are also positively correlated to the prognosis (r>0), but the results have no statistical significance (P>0.05). The correlations between post-treatment CRP, PCT, FIB, D-Dimer levels and prognosis,in decreasing order, are:CRP,D-Dimer,PCT, followed by FIB (r value: |0.487xx>|>0.371xx>|>0.322x|>|0.012|). The extent of variation of the pre-treatment and post-treatment CRP values represents negative correlations with the prognosis (r<0); the results have statistical significance (P<0.05); the correlations between the extent of variation of the pre-treatment and post-treatment PCT, FIB, D-Dimer values and the prognosis have no statistical relevance (P>0.05).Conclusion:By adopting the method of retrospective study, this research probes into the relationship between AECOPD with syndrome of phlegm-heat obstructing lung and the physicochemical indexes of western medicine. This research found that the blood CRP, PCT, FIB and D-Dimer level in patients of AECOPD with syndrome of phlegm-heat obstructing lung significantly increased before treatment, which indicates that (ⅰ) the onset of AECOPD with syndrome of phlegm-heat obstructing lungmight be associated with bacterial infections and there might be blood hypercoagulability and hyperfibrinolysis state in the patient’s body; (ⅱ) the post-treatment CRP, PCT and D-Dimer levels are relevant to prognosis, the higher these levels are,the higher incidence of in-hospital death; and (ⅲ) as indicator of prognosis, CRP shows superiority. These results not only preliminarily reveal the relevant laboratoryfeatures of AECOPD with syndrome of phlegm-heat obstructing lung, but also provide objective evidence for explaining the etiology, pathogenesis and prognosis judgment of phlegm-heat obstructing lung in accordance with the TMC theory.