慢性阻塞性肺疾病急性加重期相关生物标志物及其诊断意义

Progress and diagnostic value of related biomarkers in acute exacerbation of chronic obstructive pulmonary disease

慢性阻塞性肺疾病是临床常见的肺部疾病,其急性加重(AECOPD)是造成老年人死亡的重要原因之一,早诊断、早治疗是及早阻止疾病发展、改善预后的关键。研究发现AECOPD可能与蛋白酶-抗蛋白酶失衡、氧化应激、炎症及细胞损伤等有关,因此对相关的生物标志物进行研究有助于评估病情的严重程度及治疗情况。近10年,肺生物标志物的具体采样方法有了革命性的创新,主要包括非侵入性、半侵入性以及侵入性方法。本文从这几个方面对所获肺组织标本中的生物标志物进行总结,阐述了呼出气、呼出气冷凝液、自然痰、诱导痰、支气管肺泡灌洗液及肺组织标本中存在的相关炎症生物标志物,并试图突出其相互的联系、解释其潜在的临床作用,以期有助于AECOPD更有意义的临床评估,为治疗选择提供更多参考。

Chronic obstructive pulmonary disease（COPD） is a common lung disease in clinic, and its acute exacerbation （AECOPD） is one of the important cause of death in the elderly.Earlier diagnosis and treatment is vital for preventing the development of diseases and improving prognosis.Studies have shown that AECOPD may be related to protease-antiprotease imbalances, oxidative stress, inflammation, and cell damage and so on,so the study of related biomarkers can help assess the severity and the treatment of the illness. Innovative sampling techniques which mainly include non-invasive, semi-invasive and invasive methods have led to the identification of several pulmonary biomarkers in the past decade. Pulmonary biomarkers are sampled in the exhaled air, exhaled breath condensate, spontaneous sputum, induced sputum, bronchoalveolar lavage fluid and lung biopsies.This article try to highlight the reciprocal links and illustrate the clinical effects of these biomarkers, expecting to contribute to the more significant clinical assessment in AECOPD and provide more references for treatment options.