COPD, COPD Exacerbation Acute
Conditions
Brief summary
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) significantly increases the mortality of the patients with COPD. Guidelines have recommended systemic glucocorticoid as regular treatment. Recently, evidences have shown that systemic glucocorticoid cannot not be benefit to all of the patients with AECOPD. Thus the problem that how the clinicians can screen the patients who can benefit from systemic glucocorticoid needs to be solved urgently.
Detailed description
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) significantly increases the mortality of the patients with COPD. Guidelines have recommended systemic glucocorticoid as regular treatment. Recently, evidences have shown that systemic glucocorticoid cannot not be benefit to all of the patients with AECOPD. Thus the problem that how the clinicians can screen the patients who can benefit from systemic glucocorticoid needs to be solved urgently. A previous study found that plasma metabolome changed significantly after dexamethasone treatment in health participants. Furthermore, inter-person variability was high and remained uninfluenced by treatment, suggesting the potential of metabolomics for predicting the efficacy and side effects of systemic glucocorticoid. Our previous study found that serum metabolites profile in COPD patients differed from that in controls. Therefore, the investigators hypothesized that metabolome changes in patients with AECOPD may be associated with the efficacy of systemic glucocorticoid. In this study, the investigators will utilize ultraperformance liquid chromatography / mass spectrometry (LC-MS) and gas chromatography / mass spectrometry (GC-MS) methods for analysis of the metabolites in AECOPD patients and compare the metabolites profiles between patients with systemic glucocorticoid treatment success and treatment failure. The investigators aim to detect the metabolic biomarkers and metabolic pathways which are related to efficacy of systemic glucocorticoid and contribute to the precise treatment of COPD.
Interventions
DIAGNOSTIC_TESTSerum metabolic markers
Ultraperformance liquid chromatography / mass spectrometry (LC-MS) and gas chromatography / mass spectrometry (GC-MS) methods for analysis of the metabolites in AECOPD patients and compare the metabolites profiles between patients with systemic glucocorticoid treatment success and treatment failure.
Sponsors
Peking University Third Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who meet the diagnostic criteria for acute exacerbation of chronic obstructive pulmonary disease in GOLD 2016 and require hospitalization.
Exclusion criteria
* Bronchial asthma, bronchiectasis and other airflow obstructive diseases; * Combined with community-acquired pneumonia, hospital-acquired pneumonia or aspiration pneumonia; * Combined with severe liver and kidney insufficiency; * Malignant tumor; * Immune deficiency due to chemotherapy or HIV infection; * Received systemic hormone therapy due to acute exacerbation of chronic obstructive pulmonary disease within 1 month before this admission; * Severe trauma or stress, etc.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Metabolic markers related to systemic glucocorticoid therapy | 1 year | Through metabolomics research methods such as liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry, study the metabolic marker group profile of patients with acute exacerbation of COPD before receiving systemic glucocorticoid therapy, and look for possible systemic metabolic markers related to the short-term and long-term effects of glucocorticoids. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time from discharge to the next exacerbation | 1 year | The time interval from the patient's discharge from the hospital to the next acute exacerbation of chronic obstructive pulmonary disease |
| Side effects of glucocorticoid therapy | 1 year | Any side effects related to glucocorticoid therapy, including osteoporosis, hyperglycemia, infection, etc. |
| Mortality within 1 year | 1 year | The mortality rate of the patients within 1 year after enrollment, including overall mortality and COPD-related mortality |
| Length of hospital stay | 1 year | The time interval from admission to discharge of the patient this time |
| mMRC score | 1 year | Evaluate the severity of dyspnea through a modified version of the British Medical Research Council Respiratory Questionnaire (mMRC) |
| CAT score | 1 year | Evaluate the severity of dyspnea through the COPD assessment Test questionnaire (CAT) |
| Changes in pulmonary function | 1 year | Ventilation function and changes indicated by the patient's pulmonary function test |
| Acute exacerbation frequency | 1 year | The number of acute exacerbations of chronic obstructive pulmonary disease in the one year follow-up after enrollment |
Countries
China
Outcome results
None listed