Application value of PIV, HCAR and PCT/PLT in pulmonary infection in elderly patients with COPD

doi:10.11958/20241377

Abstract

Abstract:

Objective To investigate the application value of pan-immune-inflammation value (PIV), hypersensitive C-reactive protein (hs-CRP)/albumin (ALB) ratio (HCAR) and procalcitonin/platelet count ratio (PCT/PLT) in pulmonary infection in elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 143 elderly patients with COPD and pulmonary bacterial infection were selected as the infected group. Meanwhile, 143 elderly patients with COPD and without pulmonary infection were selected as the uninfected group. Patients in the infected group were furthrer divided into the mild group (47 cases), the moderate group (51 cases) and the severe group (45 cases) according to the degree of pulmonary infection. They were divided into the favorable prognosis group (112 cases) and the poor prognosis group (31 cases) according to the prognosis. Blood biochemical indicators, PIV, HCAR and PCT/PLT were compared between groups. The relationship between above indicators and pulmonary infection, infection degree and the prognosis was analyzed. Results Compared with the uninfected group, neutrophil (NEU), monocyte (MON), hs-CRP and PCT levels were higher, while lymphocyte (LYM) and ALB levels were lower in the infected group (P<0.05). PIV, HCAR and PCT/PLT were higher in the infected group and the poor prognosis group than those in the uninfected group and the favorable prognosis group, respectively (P<0.05). PIV, HCAR and PCT/PLT in the mild group, the moderate group and the severe group increased in sequence (P<0.05). Spearman correlation analysis showed that PIV, HCAR and PCT/PLT were positively correlated with the degree of pulmonary infection (P<0.05). Multivariate Logistic regression analysis showed that high levels of PIV, HCAR and PCT/PLT were independent risk factors for pulmonary infection in elderly patients with COPD (P<0.05), and also independent risk factors for poor prognosis in patients with pulmonary infection (P<0.05). The areas under the curve (AUC) of PIV combined with HCAR and PCT/PLT for diagnosing pulmonary infection in elderly patients with COPD and predicting poor prognosis in patients with pulmonary infection were 0.980 and 0.910 (P<0.05). Conclusion PIV, HCAR and PCT/PLT are related to COPD with pulmonary infection in the elderly. They can help to identify pulmonary infection, judge the condition of pulmonary infection and evaluate the prognosis in patients with pulmonary infection.

Key words: pulmonary disease, chronic obstructive, infections, ROC curve, platelet count, pan-immune inflammatory value, procalcitonin

CLC Number:

R563.9

Figures/Tables 10

References 22

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组别		n	男性		年龄/岁	病程/年
未感染组		143	112（78.3）		66.66±3.50	8.37±2.27
感染组		143	115（80.4）		67.01±3.61	8.65±2.50
χ²或t			0.192		0.815	0.990
组别	BMI/ （kg/m²）		高血压	糖尿病	Gold分级（1/2/3/4级）
未感染组	23.10±2.26		18（12.6）	62（43.4）	28/36/46/33
感染组	23.44±2.05		24（16.8）	71（49.7）	23/34/45/41
χ²或t	1.347		1.005	1.138	1.131

组别		n	男性		年龄/岁	病程/年
未感染组		143	112（78.3）		66.66±3.50	8.37±2.27
感染组		143	115（80.4）		67.01±3.61	8.65±2.50
χ²或t			0.192		0.815	0.990
组别	BMI/ （kg/m²）		高血压	糖尿病	Gold分级（1/2/3/4级）
未感染组	23.10±2.26		18（12.6）	62（43.4）	28/36/46/33
感染组	23.44±2.05		24（16.8）	71（49.7）	23/34/45/41
χ²或t	1.347		1.005	1.138	1.131

组别	NEU/（×10⁹/L）		PLT/（×10⁹/L）	MON/（×10⁹/L）			LYM/（×10⁹/L）
未感染组	7.02±1.22		193.29±33.80	0.73±0.22			1.37±0.35
感染组	8.42±1.22		189.32±34.65	0.93±0.20			1.01±0.21
t	9.692^＊＊		0.980	7.765^＊＊			10.496^＊＊
组别			hs-CRP（mg/L）	ALB/（g/L）		PCT/（μg/L）
未感染组			86.46±19.21	49.09±1.34		2.02（1.38，2.48）
感染组			126.32±22.31	39.45±4.91		3.60（2.66，4.26）
t或Z			16.187^＊＊	22.680^＊＊		10.730^＊＊
组别		PIV			HCAR	PCT/PLT
未感染组		706.20（496.04，1007.36）			1.76±0.39	0.01（0.01，0.01）
感染组		1 367.26（1 051.93，1 856.15）			3.27±0.81	0.02（0.01，0.02）
Z或t		10.555^＊＊			19.986^＊＊	10.675^＊＊

组别	NEU/（×10⁹/L）		PLT/（×10⁹/L）	MON/（×10⁹/L）			LYM/（×10⁹/L）
未感染组	7.02±1.22		193.29±33.80	0.73±0.22			1.37±0.35
感染组	8.42±1.22		189.32±34.65	0.93±0.20			1.01±0.21
t	9.692^＊＊		0.980	7.765^＊＊			10.496^＊＊
组别			hs-CRP（mg/L）	ALB/（g/L）		PCT/（μg/L）
未感染组			86.46±19.21	49.09±1.34		2.02（1.38，2.48）
感染组			126.32±22.31	39.45±4.91		3.60（2.66，4.26）
t或Z			16.187^＊＊	22.680^＊＊		10.730^＊＊
组别		PIV			HCAR	PCT/PLT
未感染组		706.20（496.04，1007.36）			1.76±0.39	0.01（0.01，0.01）
感染组		1 367.26（1 051.93，1 856.15）			3.27±0.81	0.02（0.01，0.02）
Z或t		10.555^＊＊			19.986^＊＊	10.675^＊＊

变量	β	SE	Waldχ²	P	OR（95%CI）
PIV	0.001	0.001	6.516	0.011	1.001（1.000~1.003）
HCAR	4.840	0.730	43.928	<0.001	126.422（30.219~528.896）
PCT/PLT	0.087	0.042	4.295	0.038	1.091（1.005~1.185）
常数项	-14.110	1.900	55.160	<0.001	0.000