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慢性阻塞性肺疾病急性加重期生物标志物研究进展
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Abstract:
慢性阻塞性肺疾病(COPD)是一种世界范围内常见的慢性炎症性疾病，其特征是持续存在的呼吸系统症状和气流受限，其主要症状包括慢性咳嗽、咳痰和呼吸困难，这些症状可能随着时间的推移而逐渐恶化。COPD在成年人群中的患病率约为10%，且发病率呈上升趋势，给个人和社会带来了巨大的健康和经济负担。慢性阻塞性肺病在世界范围内的死亡率很高，过去是第五大死因，到2030年将上升到第三位。急性加重是COPD患者住院和死亡的主要原因，46%的患者在前一年至少经历过一次急性加重。慢性阻塞性肺疾病急性加重期(AECOPD)患者预后差，住院死亡率高。因此，为了临床管理和医疗资源的合理分配，对急性加重期的个体风险进行准确的评估显得尤为关键。NLR、PLT、CRP等生物标志物与AECOPD的诊断、评估其严重程度及预后有关。在COPD患者和高风险人群中寻找分子生物学标志物，将有助于COPD的早期预防、病情评估和风险预测。这篇文章全面回顾了与COPD发病机制相关的生物学标志物，并对其在临床上的潜在应用价值进行了深入探讨。
Chronic obstructive pulmonary disease (COPD) is a common chronic inflammatory disease in the world, which is characterized by persistent respiratory symptoms and limited airflow. Its main symptoms include chronic cough, expectoration and dyspnea, and these symptoms may get worse with time. The prevalence rate of COPD in adult population is about 10%, and the incidence rate is on the rise, which brings huge health and economic burden to individuals and society. Chronic obstructive pulmonary disease (COPD) has a high mortality worldwide, which used to be the fifth leading cause of death and will rise to the third place by 2030. Acute exacerbation is the main cause of hospitalization and death of COPD patients, and 46% patients have experienced acute exacerbation at least once in the previous year. Patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) have poor prognosis and high in-hospital mortality. Therefore, for the sake of clinical management and rational allocation of medical resources, it is particularly critical to accurately evaluate individual risks in acute exacerbation. NLR, PLT, CRP and other markers are related in identifying acute exacerbation and evaluating severity and prognosis. Searching for molecular biomarkers in COPD patients and high-risk population will contribute to early prevention, disease assessment and risk prediction of COPD. This article comprehensively reviews the biological markers related to the pathogenesis of COPD, and deeply discusses their potential clinical application value.
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