Copd Clinical Trial
Official title:
Neutrophil CD64 Versus Neutrophil/Lymphocyte Ratio (NLR) as Markers Predicting In-hospital Outcome in Acute Exacerbation of COPD
Neutrophil CD64 versus Neutrophil/Lymphocyte ratio (NLR) as markers predicting in-hospital outcome in acute exacerbation of COPD
Acute exacerbation of COPD is among the most frequent reasons for hospitalisation.
Approximately 4% of the general population in the western world is admitted with an acute
respiratory disease at least once a year and nearly one fifth of hospital visits is due to
acute exacerbation of COPD. Early identifications and management of AE-COPD is an important
issue in clinical practice. AE-COPD is accompanied with various worsening respiratory
symptoms and deterioration in lung function. Also the frequency and severity of attacks is
associated with increased mortality.
During exacerbation, the inflammation in COPD is amplified in comparison with stable periods.
The increased level of inflammatory markers is associated with lung function decline. As
infection, is the main cause leading to clinical AECOPD, white blood cell counts and ESR are
the common markers to show the existence of infection in patients with COPD. Recently, other
bio markers are used. Authors have found that the high-affinity Fc receptor-CD64 is
expressed by monocytes and only weakly on resting neutrophils. The high-expression of
neutrophil CD64 (nCD64) is an early step in the host- immune response to bacterial
infection. Studies have shown that the nCD64 might be used as a bio-marker for early-onset
sepsis or bacterial infection. However, authors agreed that the value of the nCD64 in COPD
prognosis is unknown.
As most of novel bio-markers that identify the severity of acute exacerbation in COPD, are
time consuming and expensive, there is a need to use more simple tests. The
Neutrophil-lymphocyte ratio is a rapid, easy and cost-effective method derived from routine
complete blood count tests in clinical practice. The NLR could be an important marker that
assess inflammatory status in patients with COPD and could identify early, acute
exacerbation. However, this bio marker has not been widely used in the diagnosis of AECOPD.
The purpose of the present study is: 1- To measure the values of the neutrophil CD64 and NLR
in patients with AECOPD and stable COPD, 2- to correlate between nCD64, NLR and the usual
routine bio-markers as white blood cell count and erythrocyte sedimentation rate, 3- to
investigate the role of nCD64 and NLR as predictors for short term hospital outcome in this
group.
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