Acute Exacerbation Of Chronic Obstructive Pulmonary Disease Period Clinical Preliminary Study Of Heterogeneity

Objective:By detecting the levels of serum IL-6, CRP, fibrinogen,combined with its clinical characteristics,visual assessment of emphysema and other clinical data in patients with acute exacerbation of chronic obstructive pulmonary disease,to explore the heterogeneity of acute exacerbation of chronic obstructive pulmonary disease(AECOPD), and to provide the basis for the diagnosis and treatment of AECOPD.Methods:Selecting 69 eligible patients with AECOPD from Dept of Pulmonology,the Second Affiliated Hospital of Nanchang University,during August 2014 and February 2014,including 53 males and 16 females;divided into bacterial infection group,viral infection group and pauci-inflammatory group referencing Bafadhel classification.18 physical examination person in the same period in the Second Affiliated Hospital of Nanchang University,including 14 males and 4 females All hospitalized patients completed the clinical data collected at the day of admission,serum IL-6 levels were determined by enzyme-linked immunosorbent assay(EILSA),parallel chest CT, arterial blood gas analysis, blood, CRP, fibrinogen, the groups were compared between groups, and the correlation analysis conducted in patients with the detection of indicators.Results:(1) AECOPD patients with the serum CRP levels significantly are higher than the control group, which was higher than the bacterial virus group, with less inflammation group, the differences were statistically significant(P <0.05);(2) In each group of AECOPD patients with elevated fibrinogen levels compared with the control group, the difference was statistically significant(P <0.05), no significant difference(P fibrinogen concentration difference between the groups of patients AECOPD> 0.05);(3) Patients in each group AECOPD IL-6 levels significantly higher than the control group, the difference was statistically significant(P <0.05), in which groups of bacteria higher than viral group and less inflammation group, the difference was statistically significant(P <0.05);(4) AECOPD patients with emphysema visual score in each group increased significantly compared with the control group, the difference was statistically significant(P <0.05), emphysema visual score difference between the groups was not statistically significant, P values ??are greater than 0.05;(5) Each group AECOPD white blood cell count was significantly higher than the control group, the difference was statistically significant(P <0.05), in which groups of bacteria white blood cell count was significantly higher than viral group and less inflammation group, the differences were statistically significant(P <0.05);Different(6) genotyping distribution Anthonisen of AECOPD patients in each group, patients with Ⅰ type of bacteria mainly virus group with type Ⅱ, Ⅲtype-based, less inflammation in type Ⅲ group, a statistically significant difference;(7) Complications in each group of AECOPD patients have no significant difference in the probability of the presence of comorbidities(P> 0.05);(8) Less inflammation in patients with respiratory failure(especially Ⅰrespiratory failure) was significantly higher than the probability of bacterial and viral group patients, but there was no significant difference between groups of bacteria and viruses group;(9) AECOPD patients with the serum CRP and fibrinogen concentrations were significantly correlated(r = 0.353, P <0.01).Conclusion:(1) Serum CRP and serum IL-6 levels of AECOPD patients were significantly higher, significantly higher than the bacterial virus group and less inflammation group,the clinical use of antibiotics have some guiding values.(2) Considering AECOPD phenotype and Anthonisen typing can help guiding clinical application of antibiotics.(3) Complications in AECOPD patients with Different groups have no significant difference, less inflammation group with respiratory failure is higher than the other two groups.