A Functional Polymorphism in the CHRNA3 Gene and Risk of Chronic Obstructive Pulmonary Disease in a Korean Population

A genome-wide association study has identified the 15q25 region as being associated with the risk of chronic obstructive pulmonary disease (COPD) in Caucasians. This study intended as a confirmatory assessment of this association in a Korean population. The rs6495309C > T polymorphism in the promoter of nicotinic acetylcholine receptor alpha subunit 3 (CHRNA3) gene was investigated in a case-control study that consisted of 406 patients with COPD and 394 healthy control subjects. The rs6495309 CT or TT genotype was associated with a significantly decreased risk of COPD when compared to the rs6495309 CC genotype (adjusted odds ratio = 0.69, 95% confidence interval = 0.50-0.95, P = 0.023). The effect of the rs6495309C > T on the risk of COPD was more evident in moderate to very severe COPD than in mild COPD under a dominant model for the variant T allele (P = 0.024 for homogeneity). The CHRNA3 rs6495309C > T polymorphism on chromosome 15q25 is associated with the risk of COPD in a Korean population.     

Three-month Treatment Response and Exacerbation in Chronic Obstructive Pulmonary Disease

The aim of this study was to investigate relationships between acute exacerbation and Forced Expiratory Volume 1 second (FEV₁) improvement after treatment with combined long-acting beta-agonist (LABA) and inhaled corticosteroid (ICS) in patients with chronic obstructive pulmonary disease (COPD). A total of 137 COPD patients were classified as responders or nonresponders according to FEV₁ improvement after 3 months of LABA/ICS treatment in fourteen referral hospitals in Korea. Exacerbation occurrence in these two subgroups was compared over a period of 1 yr. Eighty of the 137 COPD patients (58.4%) were classified as responders and 57 (41.6%) as nonresponders. Acute exacerbations occurred in 25 patients (31.3%) in the responder group and in 26 patients (45.6%) in the nonresponder group (P=0.086). FEV₁ improvement after LABA/ICS treatment was a significant prognostic factor for fewer acute exacerbations in a multivariate Cox proportional hazard model adjusted for age, sex, FEV₁, smoking history, 6 min walk distance, body mass index, exacerbation history in the previous year, and dyspnea scale.Three-month treatment response to LABA/ICS might be a prognostic factor for the occurrence of acute exacerbation in COPD patients.

Graphical Abstract

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Association Between Air Pollution and Viral Infection in Severe Acute Exacerbation of Chronic Obstructive Pulmonary Disease

BackgroundRespiratory pathogen infections and air pollution are main causes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Air pollution has a direct effect on the airway epithelial barrier and the immune system, which can have an influence on infection. However, studies on the relationship between respiratory infections and air pollutants in severe AECOPD are limited. Thus, the objective of this study was to investigate the correlation between air pollution and respiratory pathogen in severe AECOPD.MethodsThis multicenter observational study was conducted by reviewing electronic medical records of patients with AECOPD at 28 hospitals in South Korea. Patients were divided into four groups according to the comprehensive air-quality index (CAI) used in Korea. Identification rates of bacteria and viruses of each group were analyzed.ResultsViral pathogens were identified in 270 (36.7%) of 735 patients. Viral identification rate was different (P = 0.012) according to air pollution. Specifically, the virus detection rate was 55.9% in the group of CAI ‘D’ with the highest air pollution. It was 24.4% in the group of CAI ‘A’ with the lowest air pollution. This pattern was clearly seen for influenza virus A (P = 0.042). When further analysis was performed with particulate matter (PM), the higher/lower the PM level, the higher/lower the virus detection rate. However, no significant difference was found in the analysis related to bacteria.ConclusionAir pollution may make COPD patients more susceptible to respiratory viral infections, especially influenza virus A. Thus, on days with poor air quality, COPD patients need to be more careful about respiratory infections.     

Development and validation of a low-literacy Chronic Obstructive Pulmonary Disease knowledge Questionnaire (COPD-Q)

Objective

The objective of this study was to develop a content valid, understandable, readable, and reliable Chronic Obstructive Pulmonary Disease knowledge Questionnaire (COPD-Q).

Methods

Twenty-one questions were generated as potential items to include in the COPD-Q. Twenty-two content experts provided both qualitative and quantitative assessments of two COPD-Q drafts. Ten patient volunteers completed a field test to assess clarity of individual COPD-Q items. An additional 24 patient volunteers completed a pilot test to determine internal consistency and test-retest reliability of the COPD-Q. The Flesch Reading Ease (FRE) was used to assess reading grade level of the COPD-Q.

Results

Thirteen items were rated as “essential” (content validity ratio = p < 0.05) by content experts and composed the final COPD-Q. Internal consistency, using Cronbach's alpha, was 0.72. Test-retest reliability, using intraclass correlation coefficient, was 0.90. The FRE score of the COPD-Q was 74.7 (equivalent to a 5th grade reading level).

Conclusion

The COPD-Q is a valid, readable and reliable knowledge assessment instrument for assessing COPD knowledge in patients who may have low health literacy skills.

Practice implications

Health care providers can use the COPD-Q to tailor counseling efforts according to individual patient needs, and to assess the effectiveness of their educational interventions.     

Chronic Obstructive Pulmonary Disease Assessment Test Can Predict Depression: A Prospective Multi-Center Study

This study was conducted to investigate the association between the chronic obstructive pulmonary disease (COPD) assessment test (CAT) and depression in COPD patients. The Korean versions of the CAT and patient health questionnaire-9 (PHQ-9) were used to assess COPD symptoms and depressive disorder, respectively. In total, 803 patients with COPD were enrolled from 32 hospitals and the prevalence of depression was 23.8%. The CAT score correlated well with the PHQ-9 score (r=0.631; P<0.001) and was significantly associated with the presence of depression (β±standard error, 0.452±0.020; P<0.001). There was a tendency toward increasing severity of depression in patients with higher CAT scores. By assessment groups based on the 2011 Global Initiative for Chronic Obstructive Lung Disease guidelines, the prevalence of depression was affected more by current symptoms than by airway limitation. The area under the receiver operating characteristic curve for the CAT was 0.849 for predicting depression, and CAT scores ≥21 had the highest accuracy rate (80.6%). Among the eight CAT items, energy score showed the best correlation and highest power of discrimination. CAT scores are significantly associated with the presence of depression and have good performance for predicting depression in COPD patients.     

The Effectiveness and Harms of Screening for Chronic Obstructive Pulmonary Disease: An Updated Systematic Review and Meta-Analysis

BackgroundThis study aimed to perform meta-analyses to update a previous systematic review (SR) conducted by the US Preventive Services Task Force (USPSTF) to evaluate the benefits and harms of screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults.MethodsMEDLINE, EMBASE, Cochrane Library, and regional databases were searched from their inception to January 2020. Studies for diagnostic accuracy, preventive services effect, treatment efficacy, and treatment harms were included.ResultsEighteen studies were included, and twelve of these were newly added in this update. In meta-analyses, the pooled sensitivity and specificity for COPD diagnosis using spirometry were 73.4% and 89.0%, respectively. The relative effect of smoking cessation intervention with screening spirometry, presented as abstinence rate, was not statistically significant (risk ratio [RR], 1.21; 95% confidence interval [CI], 0.87–1.67) when all selected studies were pooled, but screening on smoking cessation was effective (RR, 1.58; 95% CI, 1.14–2.19) when limited to studies with smoking cessation programs that provided smoking cessation medicines or intensive counseling at public health centers or medical institutions.ConclusionIn this study, no direct evidence for the impact on health outcomes of screening asymptomatic adults for COPD was identified similar to the previous SR. Further research is necessary to confirm the benefits of COPD screening.     

慢性阻塞性肺疾病患者抑郁、焦虑情绪调查

目的：发现慢性阻塞性肺疾病（COPD）病人伴抑郁、焦虑情绪的患病率，并分析其相关的影响因素。方法：对62例COPD患者进行了一般情况及医院焦虑抑郁量表（Hospital Anxiety and Depression Scale，HAD）问卷调查。结果：有抑郁情绪的患者42人（67．7％）。有焦虑情绪的患者的43人（69．3％）。14例Ⅲ级COPD患者中达到抑郁、焦虑症状肯定存在标准的均有13人，高达92．8％。Logistic多因素回归分析，男性比女性病人更易出现抑郁和焦虑症状（OR值分别为1．05，95％CI1．01-2．11，1．12，95％CI1．03-2．23），肺功能差的患者更易出现抑郁和焦虑症状（OR值分别为2．34，95％CI1．98-3．21，2．53，95％CI2．11-4．01）；对病情越了解的病人更易出现抑郁和焦虑症状（OR值分别为1．22，95％CI0．98-1．54，1．25，95％CI1．01-2．31）。结论：COPD患者中存在较高的抑郁及焦虑情绪障碍，肺功能受损程度是其主要影响因素。     

Word Embedding Reveals Cyfra 21-1 as a Biomarker for Chronic Obstructive Pulmonary Disease

BackgroundAlthough patients with chronic obstructive pulmonary disease (COPD) experience high morbidity and mortality worldwide, few biomarkers are available for COPD. Here, we analyzed potential biomarkers for the diagnosis of COPD by using word embedding.MethodsTo determine which biomarkers are likely to be associated with COPD, we selected respiratory disease-related biomarkers. Degrees of similarity between the 26 selected biomarkers and COPD were measured by word embedding. And we infer the similarity with COPD through the word embedding model trained in the large-capacity medical corpus, and search for biomarkers with high similarity among them. We used Word2Vec, Canonical Correlation Analysis, and Global Vector for word embedding. We evaluated the associations of selected biomarkers with COPD parameters in a cohort of patients with COPD.ResultsCytokeratin 19 fragment (Cyfra 21-1) was selected because of its high similarity and its significant correlation with the COPD phenotype. Serum Cyfra 21-1 levels were determined in patients with COPD and controls (4.3 ± 5.9 vs. 3.9 ± 3.6 ng/mL, P = 0.611). The emphysema index was significantly correlated with the serum Cyfra 21-1 level (correlation coefficient = 0.219, P = 0.015).ConclusionWord embedding may be used for the discovery of biomarkers for COPD and Cyfra 21-1 may be used as a biomarker for emphysema. Additional studies are needed to validate Cyfra 21-1 as a biomarker for COPD.     

Characteristics of Patients with Chronic Obstructive Pulmonary Disease at the First Visit to a Pulmonary Medical Center in Korea: The KOrea COpd Subgroup Study Team Cohort

The Korea Chronic Obstructive Pulmonary Disorders Subgroup Study Team (Korea COPD Subgroup Study team, KOCOSS) is a multicenter observational study that includes 956 patients (mean age 69.9 ± 7.8 years) who were enrolled from 45 tertiary and university-affiliated hospitals from December 2011 to October 2014. The initial evaluation for all patients included pulmonary function tests (PFT), 6-minute walk distance (6MWD), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnea scale, and the COPD-specific version of St. George’s Respiratory Questionnaire (SGRQ-C). Here, we report the comparison of baseline characteristics between patients with early- (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage I and II/groups A and B) and late-stage COPD (GOLD stage III and IV/groups C and D). Among all patients, the mean post-bronchodilator FEV₁ was 55.8% ± 16.7% of the predicted value, and most of the patients were in GOLD stage II (520, 56.9%) and group B (399, 42.0%). The number of exacerbations during one year prior to the first visit was significantly lower in patients with early COPD (0.4 vs. 0.9/0.1 vs. 1.2), as were the CAT score (13.9 vs. 18.3/13.5 vs. 18.1), mMRC (1.4 vs. 2.0/1.3 vs.1.9), and SGRQ-C total score (30.4 vs. 42.9/29.1 vs. 42.6) compared to late-stage COPD (all P < 0.001). Common comorbidities among all patients were hypertension (323, 37.7%), diabetes mellitus (139, 14.8%), and depression (207, 23.6%). The data from patients with early COPD will provide important information towards early detection, proper initial management, and design of future studies.     

Comparison of the Prevalence of Chronic Obstructive Pulmonary Disease Diagnosed by Lower Limit of Normal and Fixed Ratio Criteria

The Global Initiative of Chronic Obstructive Lung Disease (GOLD) guidelines define chronic obstructive pulmonary disease (COPD) in subjects with FEV₁/FVC <0.7. However, the use of this fixed ratio may result in over-diagnosis of COPD in the elderly, especially with mild degree of COPD. The lower limit of normal (LLN) can be used to minimize the potential misclassification. The aim of this study was to evaluate the impact of different definitions of airflow obstruction (LLN or fixed ratio of FEV₁/FVC) on the estimated prevalence of COPD in a population-based sample. We compared the prevalence of COPD and its difference diagnosed by different methods using either fixed ratio (FEV₁/FVC <0.7) or LLN criterion (FEV₁/FVC below LLN). Among the 4,816 subjects who had performed spirometry, 2,728 subjects met new ATS/ERS spirometry criteria for acceptability and repeatability. The prevalence of COPD was 10.9% (14.7% in men, 7.2% in women) by LLN criterion and 15.5% (21.8% in men, 9.1% in women) by fixed ratio of FEV₁/FVC among subjects older than 45 yr. The difference of prevalence between LLN and fixed ratio of FEV₁/FVC was even higher among subjects with age ≥65, 14.9% and 31.1%, respectively. In conclusion, the prevalence of COPD by LLN criterion was significantly lower in elderly compared to fixed ratio of FEV₁/FVC. Implementing LLN criterion instead of fixed ratio of FEV₁/FVC may reduce the risk of over-diagnosis of COPD in elderly people.     

Effect of Indacaterol on Cough and Phlegm in Chronic Obstructive Pulmonary Disease Patients: A Meta-Analysis of Five Randomized Controlled Trials

We investigated the effects of indacaterol on cough and phlegm in patients with stable chronic obstructive pulmonary disease (COPD). We performed a meta-analysis with five randomized controlled trials (RCTs) of indacaterol in stable COPD patients. The symptom severity was defined using the St. George''s Respiratory Questionnaire (SGRQ). We analyzed patients treated with 150 µg (n = 945) and 300 µg (n = 832) out of 3,325 patients who completed the SGRQ from five RCTs. After a 12-week treatment of 150 µg indacaterol, cough improvement was reported in 36.5% (316/866) of patients treated with indacaterol vs. 32.2% (259/804) patients treated with placebo (Relative Ratio [RR], 1.13; 95% confidence interval [CI], 0.99-1.29). Phlegm improvement was reported in 31.0% (247/798) of patients treated with indacaterol vs. 30.6% (225/736) of patients treated with placebo (RR, 1.01; 95% CI, 0.87-1.18). Dyspnea improvement was reported in 39.5% (324/820) of patients treated with indacaterol vs. 31.5% (237/753) patients treated with placebo (RR, 1.33; 95% CI, 1.03-1.71; P = 0.001, I² = 55.1%). Only dyspnea improvement was significant compared to placebo even at the 300 µg indacaterol dose. Compared to placebo, a 12-week treatment of the long-acting beta-agonist, indacaterol might not have a significant effect on cough or phlegm in stable COPD.

Graphical Abstract

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Risk of Rapid Lung Function Decline in Young Adults With Chronic Obstructive Pulmonary Disease: A Community-Based Prospective Cohort Study

It is unclear whether young adults with chronic obstructive pulmonary disease (COPD) are at an increased risk of rapid lung function decline. A total of 2,934 Korean adults aged 40–49 years who had consecutive lung function measurements were included. COPD was defined as pre-bronchodilator forced expiratory volume in 1 second (FEV₁)/forced vital capacity < lower limit of normal. The risk of rapid decline in FEV₁, defined as ≥ 60 mL/year, was assessed using multivariable logistic regression analysis. In the multivariable model, a significantly higher risk of rapid decline in FEV₁ was observed for the COPD group compared with the non-COPD group (adjusted odds ratio, 1.89; 95% confidence interval, 1.18–2.95), which was especially significant in subjects with FEV₁ less than the median value (< 110%pred) (P_interaction = 0.017) and inactive physical activity (P_interaction = 0.039). In conclusion, the risk of rapid FEV₁ decline was higher in young adults with COPD than in those without COPD, especially in those with FEV₁ less than the median value and inactive physical activity.     

Continuity of Care for Elderly Patients with Diabetes Mellitus, Hypertension, Asthma, and Chronic Obstructive Pulmonary Disease in Korea

We sought to assess continuity of care for elderly patients in Korea and to examine any association between continuity of care and health outcomes (hospitalization, emergency department visits, health care costs). This was a retrospective cohort study using the Korea National Health Insurance Claims Database. Elderly people, 65-84 yr of age, who were first diagnosed with diabetes mellitus (n=268,220), hypertension (n=858,927), asthma (n=129,550), or chronic obstructive pulmonary disease (COPD, n=131,512) in 2002 were followed up for four years, until 2006. The mean of the Continuity of Care Index was 0.735 for hypertension, 0.709 for diabetes mellitus, 0.700 for COPD, and 0.663 for asthma. As continuity of care increased, in all four diseases, the risks of hospitalization and emergency department visits decreased, as did health care costs. In the Korean health care system, elderly patients with greater continuity of care with health care providers had lower risks of hospital and emergency department use and lower health care costs. In conclusion, policy makers need to develop and try actively the program to improve the continuity of care in elderly patients with chronic diseases.     

慢性阻塞性肺疾病频繁急性加重患者的临床特征分析

目的 观察慢性阻塞性肺疾病（COPD）频繁急性加重患者与非频繁急性加重患者临床特征的差异。方法 回顾性纳入2016年1月~2018年12月合肥市第一人民医院呼吸内科住院的274例COPD急性加重患者,根据患者上一年急性加重次数分为频繁组（住院次数≥2次/年）143例和非频繁组（住院次数＜2次/年）131例,比较两组性别、年龄、病程、吸烟量、mMRC评分、共患疾病（高血压、冠心病、糖尿病）、白细胞计数、中性粒细胞百分比、淋巴细胞百分比、嗜酸粒细胞百分比、降钙素原（PCT）、血气指标（pH、PaO2、PaCO2）及血氧饱和度（SpO2）,多因素Logistic回归分析COPD频繁急性加重的危险因素。结果 两组性别、年龄、白细胞计数、淋巴细胞百分比、嗜酸粒细胞百分比、PCT、pH、PaCO2、共患疾病（高血压、冠心病、糖尿病）比较,差异无统计学意义（P＞0.05）;频繁组病程、吸烟量、mMRC评分、中性粒细胞百分比、SpO2、PaO2均高于非频繁组,差异均有统计学意义（P＜0.05）;多因素Logistic回归分析显示,病程、吸烟量、mMRC评分、中性粒细胞百分比是COPD频繁急性加重的独立危险因素。结论 COPD频繁急性加重多病程较长,患者多长期吸烟,临床中应重视病程长、吸烟量大、mMRC评分高、中性粒细胞百分比高的COPD患者,加强对其的监护管理,防止发生COPD频繁急性加重。     

慢性阻塞性肺疾病急性加重期与慢性阻塞性肺疾病并发社区获得性肺炎患者的临床对比

目的 探究慢性阻塞性肺疾病急性加重期与慢性阻塞性肺疾病并发社区获得性肺炎患者的临床对比,旨在为临床的诊断和治疗提供科学依据。方法 选取2017年3月~2018年3月于我院接受治疗的82例COPD患者为研究对象,按照随机数表法分为两组,其中观察组42例为AECOPD患者,对照组40例为COPD合并CAP患者,比较两组患者的临床症状、肺功能以及PCT、CRP水平。结果 观察组患者呼吸困难、咳脓痰、精神差、发热等临床症状的发生率均低于对照组,差异具有统计学意义（P＜0.05）。观察组患者FEV1、FVC、FEV1/FVC分别为（64.15±7.26）ml、（62.85±7.29）ml、（62.03±5.54）%,均高于对照组的（52.51±5.75）ml、（50.85±6.74）ml、（52.34±5.61）%,差异具有统计学意义（P＜0.05）。观察组患者PCT和CRP分别为（0.52±0.07）ng/L和（21.51±1.35）mg/L,均低于对照组的（0.97±0.08）ng/L和（40.05±1.57）mg/L,差异具有统计学意义（P＜0.05）。结论 AECOPD患者与COPD合并CAP患者相比,临床症状发生情况较少,肺功能较好,对患者进行相关检测,能够提高治疗效果。     

盐酸氨溴索治疗慢阻肺合并肺部感染的临床效果

目的 探究慢阻肺合并肺部感染治疗中盐酸氨溴索的临床效果。方法 选取2015年6月~2018年12月我院收治的慢阻肺合并肺部感染患者80例,随机分为参照组和实验组,每组40例。参照组采用常规药物治疗,实验组在参照组基础上联合盐酸氨溴索治疗。对比两组治疗效果和病症恢复时间。结果 实验组临床总有效率高于参照组（95.00% vs 80.00%）,差异具有统计学意义（P＜0.05）。实验组退热时间、肺部啰音恢复时间、咳嗽恢复时间分别为（3.36±2.18）d、（3.15±2.04）d、（1.52±0.43）d,均短于参照组的（6.53±2.47）d、（4.22±2.16）d、（2.26±0.46）d,差异具有统计学意义（P＜0.05）。结论 慢阻肺合并肺部感染治疗中应用盐酸氨溴索能达到良好的临床效果,可快速改善病症,缩短病程。     

戒烟与肺康复对慢阻肺患者发病机制及疗效的研究

慢性阻塞性肺疾病是目前最常见的高发病率,高伤残率,高死亡的一种疾病,发病机制比较复杂,同时吸烟在慢阻肺的危险因素中是最重要的一项,可以通过破坏支气管,加重气道炎症和气道重塑,通过气道壁和肺实质产生炎症作用,从而导致结构和功能的改变。戒烟可以有效预防慢阻肺患者早期死亡,是需要长期坚持预防的措施。肺康复治疗能明显改善患者的肺功能,在慢阻肺预防控制中起到非常重要的作用。本文主要通过介绍戒烟,早期肺康复的干预,肺康复的传统以及现代模式等方面对肺康复的效果进行综述。     

D-二聚体、NT-proBNP对慢性阻塞性肺疾病并肺动脉高压的诊断价值

目的 分析血浆D-二聚体(DD)及N端脑钠肽前体(NT-proBNP)对慢性阻塞性肺疾病(COPD)并肺动脉高压(PH)的诊断价值.方法 选择自2013年1月至2016年1月我院呼吸内科住院并确诊为COPD的500名患者,根据有无合并PH分为PH组(n=236)和非PH组(n=264),并对COPD并PH的相关危险因素进行多因素Logistic回归分析,利用ROC曲线分析相关指标的诊断价值.结果 ①单因素分析示,PH组和非PH组两组间DD(t=9.912,P<0.05)、NT-proBNP(t=5.592,P<0.05)、LDH(t=7.592,P<0.05)、HCO3-(t=6.471,P<0.05)、PO2(t=5.461,P<0.05)、PCO2(t=6.618,P<0.05)、年龄>65岁(χ2=10.307,P<0.05)、慢性心功能不全(χ2=8.307,P<0.05)差异有统计学意义;②多因素Logistic回归分析示,DD、NT-proBNP、HCO3-、慢性心功能不全是COPD并PH的独立危险因素(P<0.05);③ROC曲线示,DD曲线下面积为0.830,最佳阈值为2.18mg/L,灵敏度为0.816,特异性为0.712;NT-proBNP曲线下面积为0.794,最佳阈值为3225ng/L,灵敏度为0.820,特异性为0.782.结论 联合DD及NT-proBNP水平对COPD并PH具有较高的诊断价值.     

慢性阻塞性肺疾病患者血清Clara细胞分泌蛋白CC16和SP-D水平与肺功能的关系

目的 研究慢性阻塞性肺疾病的患者血清中Clara细胞分泌蛋白CC16和SP-D水平与患者肺功能的关系.方法 选取在2013年12月至2014年12月之间,随机选择我院呼吸内科住院及门诊受试患者.将患者随机分为三组,A组为COPD的急性加重期(AECOPD)患者组(n=25),B组为COPD稳定期患者组(n=25),C组为非COPD对照组(n=25).收集患者及对照组临床资料和血清标本,采用ELISA法测定血清CC16、SP-D水平.检测受试者第一秒钟用力呼气量占预计值的百分比(FEV1％)、FEV1和用力肺活量的比值(FEVl/FVC)、肺一氧化碳弥散量占预计值百分比(DLCO％).结果 COPD的急性加重期患者血清中Clara细胞分泌蛋白(CC16)水平最低,其次是COPD稳定期患者组,再次是对照组的受试者,其血清中Clara细胞分泌蛋白(CC16)水平最高(P＜0.05).COPD的急性加重期的患者血清中SP-D水平最高,其次是COPD稳定期患者组,再次是对照组的受试者,其血清中SP-D水平最低(P＜0.05).三组慢性阻塞性肺疾病的患者肺功能的变化与血清中CC16和SP-D水平密切相关,Clara细胞分泌蛋白CC16和与患者肺功能的关系:两者间均呈现出高度的一致性,呈正相关关系;SP-D水平与患者肺功能的关系:两者间均呈现出高度的反向性,呈负相关关系(P＜0.05).结论 COPD患者血清CC16降低而SP-D水平升高,Clara细胞分泌蛋白CC16和与患者肺功能呈正相关关系;SP-D水平与患者肺功能呈负相关关系.