Clinical Prognostic Value Of Copeptin, SAA, Hs-CRP For Short Term Outcome In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective: Assess the circulating levels of copeptin, serum amyloid A(SAA), highsensitive C reactive protein(hs-CRP) as potential prognostic biomarkers for in-hospital and6months outcomes in the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Methods: A total of103cases of AECOPD were enrolled, and copepetin, SAA, hs-CRPwere detected respectively at the time of admission, remission and6months. Evaluate thecorrelation of the three biomarkers, with clinical features, laboratory, lung functionparameters, hospitalization and6months prognosis.Results: All the circulating levels of the three biomarkers were significantly increasedat the time of AECOPD. Compared with6months, statistical difference was not found inall the biomarkers except SAA in remission. High level of copeptin when admission wascorrelated with longer hospitalization and poor prognosis in-hospital or in6months. Inmultivariate analysis, copeptin was the only factor to predict the unfavourable prognosisindependent of age, complication, hypoxia and pulmonary dysfunction. Co-existence ofhigher concentration of copeptin and previous hosipitalization in recent12months ofAECOPD was related with a worse prognosis in6months.75%of the patients who hadhistory of hosipitalization in recent12months as well as copeptin concentration≥2.78ng/ml would relapse, while the patients who had no history of hosipitalization inrecent12months and the copeptin concentration <2.78ng/ml would had a low relapse rateof7.8%. High level of SAA also correlated with longer hospitalization and poor outcomeduring hospitalization, but could not predict treatment failure in6months. Higher hs-CRPcould be found in patients of lung function Grade Ⅲ-Ⅳ rather than those of GradeⅠ-Ⅱ, but has no correlation with hospitalization stay, in-hospital and6months treatment failure.Conclusions: Copeptin was a relative ideal biomarker for AECOPD in predictingin-hospital and6months prognosis. SAA which correlated with in-hospital outcome couldbe applied as predictive biomarker for in-hospital prognosis. There was no sufficientevidence which proved hs-CRP as predictive biomarker in AECOPD.