慢性阻塞性肺疾病患者血清C-反应蛋白与BODE指数相关研究

目的探讨稳定期慢性阻塞性肺疾病（COPD）患者血清C-反应蛋白（CRP）与BODE指数的关系。方法测定稳定期COPD患者（40例）的肺功能、6分钟步行距离，评估呼吸困难程度，计算体质指数，按BODE指数评分标准进行评分。同时选择40例健康者作为对照组。用免疫散射比浊法测定COPD患者和健康者血清CRP。分析COPD患者血清CRP与BODE指数的相关性。结果稳定期COPD患者血清CRP水平[4．45（2．33～7．56）mg／L]高于对照组[2．65（2．05～3．22）mg/L]，（P=0．000）。lgCRP与BODE指数评分、呼吸困难程度呈正相关（r值分别为0．596、0．516，P均〈0．01），与第1秒用力呼气容量占预计值百分比、6分钟步行距离呈负相关（r值分别为-0．495、-0．455，P均〈0．01），与体质指数不相关（r值为0．19，P〉0．05）。多元线性回归显示，BODE指数评分是血清CRP最佳预测因素（标准化相关系数为0．596，P〈0．01）。结论血清CRP在稳定期COPD患者中增高，可在一定程度上反映COPD的全身炎症程度，并且与临床症状、生理变化、运动能力相关，可作为预测稳定期COPD患者病情及预后的有效指标。

C-reactive protein levels and BODE index in stable chronic obstructive pulmonary disease patients

Objective To investigate the relationship between C-reactive protein （CRP） levels and BODE index in stable chronic obstructive pulmonary disease （COPD） patients. Methods Between December 2008 and December 2009,40 stable COPD patients to recruit, we evaluated dyspnoea, assessed by the Modified Medical Research Council scale;degree of airflow obstruction, via FEV1 ;exercise capacity, using 6-min walk distance ; body mass index, then according the criteria computed BODE scores. CRP levels were measured in these patients and in 40 controls. Studying the relationship between CRP levels and dyspnoea, FEV1% ,6-min walk distance, body mass index, BODE scores. After logarithmic transformation of CRP,The date were analyzed using a statistical software package （ spss 16.0）. Results CRP levels were higher in COPD patients [ 4.45 （ 2.33 - 7.56 ） mg/L ]. Than controls [ 2.65 （ 2.05 - 3.22 ） mg/ L], （t = -3. 661, P 〈 0. 001 ）o The sputum lg CRP levels was positively correlated with dyspnoea and BODE scores（r =0.596 via 0. 516,respectively P 〈0. 01 ） ,negatively correlated with FEV,% and 6-min walk distance（ r = - 0. 495 via - 0. 455, respectively P 〈 0.01 ）, uncorrelated with body mass index（ r = 0. 19 ,P 〉0.05）. The results of a multivariate linear regression analysis are shown that BODE scores were the best explanatory factors of lg CRP levels （ r = 0. 596, P 〈 0.01 ）. Conclusions CRP levels were higher in stable COPD patients and can represent systemic inflammation to some degree. CRP levels were correlated with symptoms, physiologic changes and exercise ability. This should be considered when C-reactive protein levels are measured in stable chronic obstructive pulmonary disease patients.