STABİL KRONİK OBSTRÜKTİF AKCİĞER HASTALARINDA İNFLAMATUVAR BELİRTEÇLER; C-REAKTİF PROTEİN, FİBRİNOJEN ve LÖKOSİT

Year 2011, Volume: 25 Issue: 3, 145 - 152, 01.12.2011

Yasemin Toraman Esin Yentürk Dilek Kanmaz Sema Altun Barış Yılmaz Yasemin Bahar Esin Tuncay

Abstract

KOAH hastalarında stabil evrede inflamatuar proçesin devam edip etmediğini ve inflamatuar mediyatörlerin hava akımı kısıtlılığı ile ilişkisini araştırmayı amaçladık. Olgularımız, hastanemiz polikliniğine başvuran stabil KOAH tanısı almış 48 hastadan, kontrol grubu ise aktif sigara içicisi olmayan 21 sağlıklı gönüllüden seçildi. Her iki gurubun da yaş, boy, kilo, sigara kullanım süreleri sorgulandı, solunum fonksiyon testleri, hemogram, CRP ve fibrinojen değerlerine bakıldı. KOAH grubunda arter kan gazları, kontrol grubunda satürasyon değerleri tetkik edildi. Çalışmamızda, KOAH grubunun yaş ortalaması 60±9, kontrol grubunun ise 34±9 idi. KOAH grubundaki olgularda lökosit (p:0.00) ve CRP (p:0.02) düzeylerinin kontrol grubuna göre anlamlı derecede yüksek olduğu, ancak fibrinojen (p:0.149) düzeyinde gruplar arasında farklılık bulunmadığı tespit edildi. Stabil KOAH evreleri arasında, CRP (p:0.9) ve lökosit (p:0.7) düzeylerinde anlamlı farklılık tespit edilmedi. İleri evre KOAH olgularında fibrinojen ortalaması diğer evrelere göre yüksekti, ancak istatistiksel olarak anlamlı farklılık bulunmadı (p:0.228). Sonuç olarak stabil KOAH olgularında CRP ve lökosit gibi inflamatuvar belirteçlerin yüksek olduğu, stabil KOAH ve kontrol grubunun fibrinojen düzeyleri arasında ilişki olmasa da, fibrinojen ile FEV1 arasında ters orantılı ve anlamlı bir ilişki olduğu (p:0.047), ayrıca fibrinojenin yaşla paralel olarak arttığı sonucuna varıldı (p:0.013).

Keywords

KOAH, lökosit, CRP, fibrinojen, FEV1

INFLAMMATORY MARKERS IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG DISEASE; C-REACTIVE PROTEIN, FIBRINOGEN, LEUKOCYTE

Abstract

In this study we aimed to investigate, if the inflammatory process is going on or not at stable phase of COPD patients and relation of inflammatory mediators with airflow obstruction. We selected our cases from our outpatient clinic patients among the ones diagnosed as stable COPD and healthy volunteers who weren't active smokers. Both groups were classified for age, height, weight, smoking duration and checked for pulmonary function test, hemogram, CRP, fibrinojen levels respectively. We checked arterial blood gas in COPD group and saturation levels in control group. In our study, average age of patients in COPD and control groups were 60±9 and 34±9 respectively. We revealed that CRP (p:0.02) and leukocyte levels (p:0.00) at COPD patients were higher than control group and this was statistically significant. But there wasn't any significant difference between two groups according to fibrinogen levels (p:0.149). There wasn't a significant difference between CRP (p:0.9) and leukocyte (p:0.7) levels at stable COPD phases. Average of fibrinogen levels were higher at patients with severe disease than other phases but this wasn't statistically significant (p:0.228). In conclusion, we revealed that CRP and leukocyte levels were higher at stable COPD patients. Although there was not a relation between fibrinogen levels of stable COPD and control groups, there was an inversely proportional and significant relation between fibrinogen and FEV1 (p:0.047). In addition we found that fibrinogen levels were increasing with age (p:0.013).

Keywords

COPD, leukocyte, CRP, fibrinogen, FEV1

References

• published online ahead of print as doi: 1183/09031936.06.00109605.
• Wu SJ, Chen P, Jiang XN, Liu ZG. C-reactive protein level and the correlation between lung function and CRP levels in patients with chronic obstructive pulmonary diseases. Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 30(4): 444-6. Mannino DM, Ford ES, Redd SC. Obstructive and restrictive lung disease and markers of inflammation:data from the third National Health and Nutrition Examination. Am J Med ; 114: 758-62. Gan Wq, Man SFP, Senthilselvan A, Sin DD. Association between chronic obstructive COPD patients. Eur Respir J 2006 Feb 2;
• Dahl M, Tybjerg-Hansen A, Vestbo J, et al. Elevated Plasma Fibrinojen with Reduced Pulmonary Function and Increased Risk of Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2001; 164: 1008-11.
• Hiroyasu I, Shimamoto T, Sato S. Passive Smoking and Plasma Fibrinojen Concentra- tions. Am J Epidemiol 1996;144: 1151-4.
• Mennen LI, Balkau B, Charles MA, D’Hour A, et al. Gender differences in the relation between fibrinojen, tissue-type plasminojen activator antigen and markers of insulin resistance: effects of smoking: DESIR Study Group. Thromb Haemost 1999; 82: 1106
• Eliasson M, Asplung K, Evrin PE, Lundbland D. Relationship of cigarette smoking and snuff dipping to plasma fibrinogen, fibrino- lytic variables and serum insulin: the Nort- hern Sweden MONICA Study. Atherosclerosis ; 113: 41-53. Hunter KA, Garlick PJ, Broom L, et al. Effect of smoking and abstention from smoking on fibrinogen synthesis in humans. Clinical Science 2001; 100: 459-65.
• Sinha S, Luben RN, Welch A, et al. Fibrinojen and cigarette smoking in men and women in the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) population. European Journal of Cardiovascular Pre- vention and rehabilitation 2005; 12(2): 144
• Arslan S, Yıldız F, Argun Barıfl S ve ark. Stabil ve Ataktaki Kronik Obstrüktif Akciğer Hastalığı Tanılı Bireylerde Sistemik İnflamas- yon ve Komorbiditeler. Türk Toraks Derneği yıllık kongresi sözlü bildiri. SS302. Noguera A, Busquets X, Sauleda J, et al. Expression of adhesion molecules and G proteins in circulating neutrophils in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 158: 1664-8.
• Bartu Saryal S, Acıcan T. (eds) Epidemiyoloji ve risk faktörleri. In: Güncel Bilgiler Iflığında KOAH, Bilimsel Tıp Kitabevi, Ankara 2003; s:12-32. Contraception 1994; 49: 579-92.
• İZMİR GÖ⁄ÜS HASTANESİ DERGİSİ In: Fishman AP, Elias JA, et al. Pathogenetic Processes. Fishman’s Pulmonary Disease and Disorders. 4. Ed, McGraw-Hill, 2008; 717. Yazıflma Adresi: Dr. Yasemin TORAMAN
• Yedikule Göğüs Hastalıkları ve Göğüs Cerrahisi, Eğitim ve Arafltırma Hastanesi, Göğüs Hastalıkları, İSTANBUL e-posta: [e-mail]