Objective To determine if the levels of high-sensitivity C-reactive protein ( hs-CRP)and fibrinogen ( Fbg) can predict the risk of acute exacerbation of chronic obstructive pulmonary disease ( COPD) . Methods hs-CRP was measured by latex-enhanced immunoturbidimetric assay and Fbg was assessed by Von Clauss method. The number of exacerbations was recorded during a 6-month follow-up period. Results Fifty patients with stable COPD were enrolled in the study, of whom48 patients completed the trial and two patients dropped out. During the follow-up, 16 patients had once or more acute exacerbations while other 32 patients had no acute exacerbation. The patients were stratified into two groups ( A-exacerbation, B-no exacerbation) . At the baseline, the patients of the group A had lower FEV1 than thegroup B [ ( 1. 1 ±0. 4) L vs. ( 1. 4 ±0. 5) L, P lt;0. 05] . And the group A had higher hs-CRP and Fbg than the group B [ hs-CRP: ( 4. 6 ±3. 3) mg/L vs. 4. 3 mg/L( IQR 5. 5 mg/L) , P lt;0. 05] ; Fbg: ( 3. 8 ±0. 7) g/L vs. ( 3. 1 ±0. 5) g/L, P lt;0. 05] . Nine of 16 patients with a higher level of hs-CRP( hs-CRP gt;3 mg/L) had acute exacerbations. Seven of other 32 patients with normal hs-CRP level had acute exacerbations. The difference in the acute exacerbations rate between the two groups was significant ( 56. 25% vs. 21. 88% , P lt;0. 05) . All four patients with a higher level of Fbg( Fbg gt;4 g/L) had acute exacerbations. Twelve of 44 patients with normal Fbg level ( Fbg≤4 g/L) had acute exacerbations. The patients with Fbg more than 4 g/L had a higher rate of acute exacerbations( 100% vs. 27. 27%, P lt;0. 05) . After adjusting by age, bodymass index ( BMI) , FEV1 , tobacco consumption and other chronic diseases, the risk of acute exacerbation in individuals with baseline hs-CRP gt;3 mg/L was 9. 33 times higher than those with baseline hs-CRP≤3 mg/L ( 95% CI 1. 870-46. 573) . Conclusion Higher level of hs-CRP is associated with the high risk of exacerbation in patients with COPD.
Objective To evaluate if the difference between slow vital capacity ( VC) and forced vital capacity ( FVC) could be used to predict severity of airflow limitation in patients with stable chronic obstructive pulmonary disease ( COPD) . Methods VC and FVC were measured in 200 patients with COPD [ 159 males;mean FEV1 , ( 49.31 ±15.75) % of predicted] and 114 healthy controls [ 64 males; mean FEV1 , ( 99.67 ±13.62) % of predicted] . Results The difference between VC and FVC ( VC - FVC) , which showed a negative correlation with FEV1 of predicted ( r=- 0.412, Plt;0.001) , was significantly larger in the COPD patients than that in the controls [ ( 145.40 ±157.50) mL vs. ( 21. 10 ±61. 30) mL, Plt; 0. 001] . The FVC/VC ratio was significantly lower in the COPD patients than that in the controls [ ( 93. 61 ± 7. 10) % vs. ( 99.27 ±2.24) % , P lt; 0.001] , and was positively correlated with FEV1 of predicted in the COPD patients ( r =0.517, P lt;0.001) . There was significant difference in VC - FVC in the COPD patients with FEV1≥50% of predicted ( 5 patients in GOLD level 1 and 74 patients in GOLD level 2) and those patients with FEV1 lt;50% of predicted ( 106 patients in GOLD level 3 and 15 patients in GOLD level 4) [ ( 78.23 ±108.26) mL vs. ( 189.26 ±169.21) mL, P =0.003] . Conclusion The difference between VC and FVC and the FVC/VC ratio, which are more easily obtained from spirometric test, are able to detect severity of airflow limitation in patients with stable COPD.