慢性閉塞性肺疾患における炎症バイオマーカーと悪化
Mette Thomsen1, Truls Sylvan Ingebrigtsen, Jacob Louis Marott
1Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark.
JAMA
|June 13, 2013
まとめ
慢性閉塞性肺疾患 (COPD) の患者におけるC反応性タンパク質 (CRP),フィブリノゲン,白血球数などの炎症バイオマーカーの増加は,悪化のリスクを大幅に増加させます. この関連性は,より軽度のCOPD症例や,以前の悪化のない症例でも当てはまり,リスク評価における有用性を示唆しています.
科学分野:
- 肺内医学 肺内医学 肺内医学
- バイオマーカー バイオマーカー
- 炎症 炎症 炎症 炎症 炎症
背景:
- 慢性阻害性肺疾患 (COPD) の悪化は,患者に対して長期的に重大な悪影響を及ぼします.
- 悪化のリスクが高い個人を特定することは,積極的な管理に不可欠です.
研究 の 目的:
- 炎症バイオマーカーの上昇と,安定したCOPD患者の悪化のリスクとの関連を調査する.
- ベースラインの炎症マーカーレベルが将来のCOPD悪化を予測できるかどうかを判断する.
主な方法:
- 61,650人の参加者を含む前向きなコホート研究で,6,574人がスピロメトリーに基づいてCOPDと診断されました.
- C反応性タンパク質 (CRP),線維原素,白血球数のベースライン測定は,安定した疾患期間中に取られた.
- 悪化は,経口用コルチコステロイドの治療または入院によって定義され,バイオマーカーのレベルは,高または低に分類されました.
主要な成果:
- 炎症バイオマーカーが上昇した個人は,頻繁に悪化するリスクが有意に増加したことを示しました.
- リスクは,バイオマーカーの数が増加するにつれて上昇し,1年目の確率比率は1.2 (1バイオマーカー) から3.7 (3バイオマーカー) であった.
- 炎症性バイオマーカーは,悪化の予測モデルを改善し,さまざまなCOPD重症度および病歴サブグループで一貫した結果が得られました.
結論:
- CRP,フィブリノゲン,白血球数の同時に上昇したレベルは,COPDの悪化のリスクが高いと関連しています.
- この関連性は,より軽度のCOPDまたは前述の悪化歴のない患者でも存在します.
- COPDリスクの階層化におけるこれらのバイオマーカーの臨床的有用性を確立するために,さらなる研究が必要である.
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