外周血中EOS、PCT、CRP水平对甲强龙治疗老年COPD合并肺部感染患者疗效的预测价值

Prognostic Value of EOS, PCT and CRP in Peripheral Blood of Meprednisolone-treated Elderly Patients with COPD Complicated with Pulmonary Infection

【目的】探讨血嗜酸粒细胞(EOS)、C反应蛋白(CRP)、降钙素原(PCT)水平对甲强龙治疗老年慢性阻塞性肺疾病(COPD)合并肺部感染患者疗效的预测价值。【方法】选择2019年11月至2022年12月西安市第五医院收治的78例老年COPD合并肺部感染患者,检测所有患者外周血中EOS、CRP及PCT的表达水平。所有患者均在常规治疗基础上给予甲强龙静脉滴注治疗,根据患者临床疗效分为有效组和无效组,采用Logistic回归分析甲强龙治疗老年COPD合并肺部感染患者疗效的影响因素;采用受试者工作特征(ROC)曲线评估EOS、CRP及PCT对甲强龙治疗老年COPD合并肺部感染患者疗效的预测价值。【结果】78例老年COPD合并肺部感染患者中,治疗有效患者52例(有效组),占比66.67%;26例治疗无效(无效组),占比为33.33%。有效组EOS、CRP及PCT水平均低于无效组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示:EOS、CRP及PCT水平均是甲强龙治疗老年COPD合并肺部感染患者疗效的影响因素(P<0.05);ROC曲线分析结果显示:EOS、CRP、PCT水平及三者联合预测甲强龙治疗老年COPD合并肺部感染患者疗效的曲线下面积(AUC)分别为0.815、0.831、0.795及0.894。【结论】EOS、CRP及PCT水平均是影响甲强龙治疗老年COPD合并肺部感染患者疗效的相关因素,可预测甲强龙治疗老年COPD合并肺部感染患者的临床疗效。

【Objective】To explore the predictive value of blood eosinophils(EOS),C-reactive protein(CRP),and serum procalcitonin(PCT)levels in elderly patients with chronic obstructive pulmonary disease(COPD)and pulmonary infection treated with methylprednisolone.【Methods】A total of 78 elderly patients with COPD and pulmonary infection admitted to Xi'an Fifth Hospital from november 2019 to December 2022 were selected as the study subjects.The expression levels of EOS,CRP,and PCT in the peripheral blood of all patients were measured.Patients received intravenous infusion of methylprednisolone in addition to conventional treatment,and they were divided into the effective and ineffective groups based on their clinical efficacy.Logistic regression was used to analyze the relevant factors that affected methylprednisolone treatment effectiveness of elderly COPD patients with pulmonary infection.The receiver operating characteristic(ROC)curve to evaluate the predictive value of EOS,CRP,and PCT in methylprednisolone treatment of elderly COPD patients with pulmonary infection.【Results】Among 78 elderly COPD patients with pulmonary infection,52 patients(in the effective group)were treated effectively,accounting for 66.67%.The remaining 26 cases were ineffective(in the ineffective group),accounting for 33.33%.The levels of serum EOS,CRP and PCT in the effective group were lower than those in the ineffective group.The differences were statistically significant(P<0.05).Logistic regression analysis showed that serum EOS,CRP and PCT levels were all influencing factors of the efficacy of methylprednisolone in the treatment of elderly COPD patients with pulmonary infection(P<0.05).ROC analysis showed that the area under the curve(AUC)of serum EOS,CRP,PCT levels and their combination to predict methylprednisolone-treated efficacy of elderly COPD patients with pulmonary infection were 0.815,0.831,0.795 and 0.894,respectively.【Conclusion】The levels of EOS,CRP,and PCT are all related factors that affect the efficacy of methylprednisolone in elderly COPD patients with pulmonary infection.The levels of EOS,CRP,and PCT can predict the clinical prognosis of methylprednisolone treatment in elderly COPD patients with pulmonary infection.