An Analysis Of The Early Stage Indicators Of Renal Injury In Patients With Acute Exacerbated Chronic Obstructive Pulmonary Disease

Object:To analyse the early renal function damage index of patients with acute exacerbation of chronic obstructive pulmonary disease and make related analysis. At the same time, we explored the changes of the early stage indicators of renal injury before and after regular treatment.Methods : We collected 76 patients with acute exacerbation of chronic obstructive pulmonary disease as AECOPD group, 30 healthy people as the control group,and recorded the clinical data and mensurated serum creatinine, blood urea nitrogen(BUN),C reactive protein(CRP), determination of artery blood, urine α1-microglobulin,(α1-MG) and urine β2-microglobulin(β2-MG), urinary albumin/creatinine ratio(UACR). At the same time, we get the pulmonary function tests results.We compared general information and early renal damage index among groups and analyzed the correlation of early renal damage index.In addition, after having regular medical therapy according to the GOLD2013 guidelines for the treatment of patients with AECOPD, we repeated the above indicators measuring process when the patients were close to the stable period of state.Results : Compared with the control group, the serum creatinine, urea nitrogen and glomerular filtration rate of the AECOPD patients showed no statistical significance(P > 0.05). and urine α1-MG, β2-MG, urinary albumin/creatinine ratio(UACR) in patients increased significantly(P < 0.05), and the urine α1-MG showed a negative correlation with oxygen partial pressure(PO2), FEV1/FVC%(r =-0.24,-0.30,-0.31),and was positively correlated with CRP(r value of 0.27); urinary β2-MG was negatively correlated with FEV1%, FVC and FEV1/FVC(r =-0.42,-0.40, 0.27); urinary albumin/creatinine ratio(UACR) showed a negative correlation with FEV1%(r value is0.15), and was positively correlated with CRP(r value of 0.33). According to the GOLD2013 guideline, the analysis of further subgroups showed that as the level of pulmonary function was significantly increased, the urine α1-MG, β2-MG and urinary albumin to creatinine ratio(UACR) was significantly higher than that of the normal control group, this difference was statistically significant(P<0.05). In addition,according to the guideline after having regular medical therapy, the pulmonary function result and CPR index of AECOPD group were improved compared with former situation, serum CRP, urine α1-microglobulin, β2-microglobulin, urinary albumin to creatinine ratio(UACR) were lower than before, but still higher than the control group,and this difference made great statistical significance(P<0.05).Conclusion:The patients with acute exacerbation of chronic obstructive pulmonary disease have early renal damage, urine α1-microglobulin, β2-microglobulin,and urinary albumin to creatinine ratio(UACR) could be taken as the early indicators of the renal damage, and they are closely related to hypoxia, inflammation and pulmonary function’s declining. A regular and positive medical therapy will have positive effects on protecting renal function.