The Inspection And Clinical Significance Of The High Mobility Group Box-1and High Sensitivity C-reactive Protein In Patients With Chronic Obstructive Pulmonary Disease

objects：Chronic Obstructive Pulmonary Disease (COPD) is a kind ofmulti-factor caused chronic airway inflammatory disease with the trait ofprogressive airflow limitation. The COPD pulmonary inflammation mainlyconcentrates in small airways, terminal pulmonary tissue and pulmonaryvascular; many inflammatory mediator, inflammatory cells and cytokines areinvolved in COPD inflammatory reaction; and COPD shows up as a mildsystemic inflammatory change. High mobility group box1(HMGB1) is a keylate-stage inflammatory medium in the pathophysiological process of variousrespiratory diseases (including pulmonary fibrosis, acute lung injury, chronicobstructive pulmonary disease, pneumonia, etc.), playing a quite significantrole in infective inflammation and immunoreaction. The density of HMGB1shows the severity of organism inflammation and tissue injury, meanwhile itclosely relates to the prognosis of the disease. By inspecting the HMGB1andhs-CRP level in patient of COPD, this study analyzes its correlation with thepercentage of FEV1in the predicted value, so as to investigate the function ofHMGB1and hs-CRP in COPD pathogenesis and in judging the severity ofAECOPD patients’ condition.Methods: Choose49cases of AECOPD patients who are in theAffiliated Hospital of North Sichuan Medical College from July2012to Dec,2012as the AECOPD group, and separate them into two sub-groups:24casesfor mild-moderate group,25cases for severe-profound group; conduct symptomatic treatments (anti infection, oxygen inhalation, spasmolytic andasthma relieving, antitussive treatment, etc.) on patients, and select thosewhose acute attack sign and symptom improve to be COPD remission group;the25cases of simultaneous outpatients who are healthy in physicalexamination as control group. When finishing the collection of cases, measureand define the HMGB1level of the subjects through enzyme-linkedimmunosorbent assay (ELISA); and test the pulmonary function of AECOPDpatients (test the percentage of FEV1in predicted value, FEV1/FVC). Themeasurement data in the experiment is shown in average±standard deviation(x±s), the analysis is done through statistic software: SPSS16.0, and thedata is checked by t check and Pearson correlation analysis with a deviationof P<0.05, thus this experiment is statistically significant.Results:(1)The concentration of the high mobility group box-1(HMGB-1) and high sensitivity C-reactive protein (hs-CRP) in the serum ofpatients with the COPD groups: the levels of serum HMGB-1and hs-CRP inAECOPD groups are7.76±0.80）ng/ml、（60.55±41.37）mg/L. The levels ofserum HMGB-1and hs-CRP in the COPD groups of stable period are（6.28±0.75）ng/ml、（18.12±12.26）mg/L. However, the levels of serumHMGB-1and hs-CRP in the control groups are(5.53±0.66)ng/ml、（3.22±3.12）mg/L. The levels of serum HMGB-1and hs-CRP in AECOPDgroups are higher than COPD groups of stable period and control groups, andthe differences are statistically significant in the binary comparison, P<0.05.The levels of serum HMGB-1and hs-CRP in the COPD groups of stableperiod are higher than control groups, and the differences are statisticallysignificant in the binary comparison, P<0.05.(2) The concentration of thehigh mobility group box-1(HMGB-1) and high sensitivity C-reactive protein (hs-CRP) in the serum of type of classification of COPD: the levels ofserum HMGB-1and hs-CRP in weight-very severe of AECOPD groups arerespectively as （8.24±0.60） ng/ml、（69.23±43.49） mg/L； as this inlight-moderate groups are respectively as（7.27±0.67）ng/ml、（51.51±37.82）mg/L. The levels of serum HMGB-1and hs-CRP in weight-very severe ofAECOPD groups are higher than COPD groups of light-moderate and controlgroups, and the differences are statistically significant in the binarycomparison, P<0.05. The levels of serum HMGB-1and hs-CRP in the COPDgroups of stable period are higher than control groups, and the differences arestatistically significant in the binary comparison, P<0.05.(3) The comparisonof the sensitivity of AECOPD of the levels of serum hs-CRP、the count ofwhite blood cell and the percentage of neutrphils: hs-CRP is greater than9mg/L as a standard,42cases were positive in49AECOPD patients. Thepositive rate is85.71%. The count of white blood cell is greater than10*109/L,25cases were positive, so the positive rate is45.95%.The percentage ofneutrphils is greater than70%,27cases were positive, so the positive rate is64.86%.Therefore,the sensitivity of diagnosis of AECOPD are85.71%、45.95%、64.86%.Thus for the diagnosis of AECOPD hs-CRP is better than thecount of white blood cell and the percentage of neutrphils.(4) The serumconcentration of HMGB-1and hs-CRP is a positive correlation in patient withAECOPD (r=0.51).(5) The serum concentration of HMGB-1and FEV1%predicted are negative correlation in patient with AECOPD (r=-0.64), and theserum concentration of hs-CRP and FEV1%predicted are negative correlationin patient with AECOPD (r=-0.48).Conclusion:(1) The serum concentration of HMGB-1and hs-CRP inpatient with AECOPD is higher than controls, and a positive correlation is between each other. It is suggested that they take part in the airwayinflammation.(2) The serum concentration of HMGB-1in AECOPD groupsare higher than COPD groups of stable period, and in weight-very severe ofAECOPD groups are higher than COPD groups of light-moderate. The serumconcentration of HMGB-1and FEV1%predicted are negative correlation inpatient with AECOPD. The result suggests that the HMGB-1is a biomarkerof the severity of COPD.(3) The serum concentration of hs-CRP in AECOPDgroups is higher than COPD groups of stable period and control groups. It issuggested that the infection is controlled to reduce the level of hs-CRP. Thehs-CRP is a biomarker of the controlling infection of COPD.(4) Thus for thediagnosis of AECOPD hs-CRP is better than the count of white blood cell andthe percentage of neutrphils.