Abstract 【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.
GONG Lei,FENG Jinmei. Prognostic Value of EOS, PCT and CRP in Peripheral Blood of Meprednisolone-treated Elderly Patients with COPD Complicated with Pulmonary Infection[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(12): 1864-1867.
[1] LABAKI W W, ROSENBERG S R. Chronic obstructive pulmonary disease[J].Ann Intern Med,2020, 173(3):17-32.
[2] 朱涛. 布地奈德雾化吸入与静脉滴注甲强龙治疗慢性阻塞性肺病的疗效比较[J].吉林医学,2016,37(7):1687-1688.
[3] 陈学梅,祁蕙燕,成志飞. 老年COPD合并肺部感染患者呼出气一氧化氮水平与EOS、PCT、CRP水平相关性分析[J].中国急救复苏与灾害医学杂志,2022,17(4):482-485.
[4] SAGER R, KUTZ A, MUELLER B, et al. Procalcitonin-guided diagnosis and antibiotic stewardship revisited[J].BMC Med,2017,15(1):15.
[5] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[6] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.成人获得性肺炎基层诊疗指南(2018)[J].中华全科医师杂志,2003.
[7] ARIF E, NIHALANI D. Beta2-adrenergic receptor in kidney biology: A current prospective[J].Nephrology,2019, 24(5):497-503.
[8] CALZETTA L, CAZZOLA M, MATERA M G, et al. Adding a LAMA to ICS/LABA therapy: A meta-analysis of triple combination therapy in COPD[J].Chest,2019, 155(4):758-770.
[9] AL-SALAMA Z T, FRAMPTON J E. Glycopyrronium/formoterol: a review in COPD[J].Drugs,2019, 79(13):1455-1466.
[10] 张春辉,刘少滨,王集红,等. 老年哮喘和慢性阻塞性肺疾病重叠患者呼出气一氧化氮水平与嗜酸性粒细胞及炎症因子的关系[J].中华老年医学杂志,2020,39(11):1279-1282.
[11] WU M, TONG X, WANG D G, et al. Soluble intercellular cell adhesion molecule-1 in lung cancer: A meta-analysis[J].Pathol Res Pract,2020, 216(10):1530-1534.
[12] SAMARAKOON R, HIGGINS S P, HIGGINS C E, et al. The TGF-β1/p53/PAI-1 signaling axis in vascular senescence: Role of caveolin-1[J].Biomolecules,2019, 9(8):341-345.
[13] DERINOZ-GULERYUZ O, FIDANCI I, MEN-ATMACA Y. Nebulized ipratropium bromide-induced anisocoria: Why is anisocoria observed[J].Iran J Allergy Asthma Immunol,2021, 20(1):125-128.
[14] KAWAMATAWONG T, APIWATTANAPORN A, SIRICHAROONWONG W. Serum inflammatory biomarkers and clinical outcomes of COPD exacerbation caused by different pathogens[J].Int J Chron Obstruct Pulmon Dis,2017,12(3):1625-1630.
[15] MATHIOUDAKIS A G, BIKOV A, FODEN P, et al. Change in blood eosinophils following treatment with inhaled corticosteroids may predict long-term clinical response in COPD[J].Eur Respir J,2020,55(5):174-176.
2023, Vol. 40 
