Expression Of Neutrophil Gelatinase-associated Lipocalin In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

BackgroundChronic obstructive pulmonary disease?COPD?is a common and frequently encountered disease in respiratory system that characterized by persistent airflow limitation.Acute exacerbation of COPD can accelerate the patient's lung function decline and increase mortality,besides,it increased economic burden,greatly reducing their quality of life.Chronic airway inflammation airway remodeling are important pathological changes of COPD.The key to the treat of COPD is relieve inflammation which could be improve the condition and be benefit to the prognosis of patients.Many inflammatory cytokines be found in COPD,but the mechanism is unclear.Neutrophil gelatinase-associated lipocalin?NGAL?is a new-found inflammatory cytokine,some study show NGAL up-regulates in the patients of COPD.NGAL could be involve in the airway inflammation and aieway remodeling.ObjectiveTo observe the concentration of plasma neutrophil gelatinase-associated lipocalin with the change of treatment in chronic obstructive pulmonary disease acute exacerbation?AECOPD?and the controls.Study the meaning of plasma NGAL in evaluating the severity of AECOPD.Using self controlled study to determine the plasma NGAL before treatment and after treatment.Forty-six cases of patients with AECOPD in Fuyang city people's hospital from June 2015 to April 2016 and 25 healthy controls were recruited into the study.Both of the plasma NGAL of pretherapy and post-treatment of AECOPD and controls' plasma NGAL were measured by ELISA.AECOPD group was detected in CRP levels,white blood cell count?WBC?and classification?NE%?,PO₂,PCO₂,SpO₂,FEV1%,hospitalization time and other clinical data.Results1,In AECOPD patients,the plasma concentrations of NGAL pretherapy and post-treatment of AECOPD were?112.18±20.96??g/L,?79.02±15.39??g/L,and?64.74±13.20??g/L in controls,there's a significant difference between the three groups?p<0.05?.2,The CRP levels of pretherapy is higher than post-treatment in AECOPD patients,and both of them higher than controls?p<0.05?.3,The white blood cell count and classification?NE%?in AECOPD patients decrease after treatment obviously,the white blood cell count and classification?NE%?of post-treatment of AECOPD have no different with controls?p<0.05?.4,A receiver operating characteristic?ROC?curve of the sensitivity and1-sepcificity of NGAL levels to discriminate the pretherapy and post-treatment of AECOPD,for comparison,the ROC curves of CRP/WBC and neutrophils percentage are presented.the area under the curves of NGAL/ CRP/WBC and neutrophils percentage are?AUC=0.869,p?0.001???AUC=0.822,p?0.001???AUC=0.697,p=0.002???AUC=0.799,p?0.001?respectively.The cut-off points of NGAL is 92.58?g/L,the sensitivity and specificity are 80% and 80%.5,In patients with AECOPD frequently NGAL levels of patients were significantly higer than the patients with AECOPD annually.6.NGAL levels of different stages have no difference.Methods7.In AECOPD patients,the levels of NGAL were positively correlated with CRP,neutrophil cell count,hospitalization time,and negatively correlated with severity of pulmonary function?p<0.05?.Conclusions The plasma NGAL of AECOPD decreases after treatment,NGAL is a biomaker in AECOPD and to evaluate severity of AECOPD.