The early diagnostic value of serum CD71 and ACTA levels for elderly COPD complicated with pulmonary infection
Objective To analyze the early diagnostic value of serum transferrin receptor 1(CD71)and activin A(ACTA)levels in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection,and to identify the pathogen composition of elderly patients with COPD complicated with pulmonary infection.Methods A total of 185 elderly COPD patients admitted to our hospital were included as the research subjects,and were grouped into a combined group(102 cases)and an non combined group(83 cases)based on whether the patients had complicated pulmonary infection.Clinical data of the research subjects were collected.ELISA method was applied to detect serum CD71 and ACTA.Sputum samples were collected from patients in the combined group and pathogenic bacteria were identified.Logistic regression was applied to analyze the influencing factors of pulmonary infection in elderly COPD patients.ROC was applied to analyze the early diagnostic value of serum CD71 and ACTA in elderly patients with COPD complicated with pulmonary infection.Results The proportions of hypertension,diabetes,smoking history,GOLD grade＞grade Ⅱ,hospitalization time＞14 days,mechanical ventilation time＞2 days,CD71,ACTA,CD8+in the combined group were higher than those in the non combined group,and the CD4+and CD4+/CD8+were lower than those in the non combined group(P＜0.05).CD71,ACT A,and CD8+were risk factors for pulmonary infection in elderly COPD patients,while CD4+and CD4+/CD8+were protective factors for pulmonary infection in elderly COPD patients(P＜0.05).The serum CD71 and ACTA levels in the moderate and severe groups were higher than those in the mild group,and the serum CD71 and ACTA levels in the severe group were higher than those in the moderate group(P＜0.05).The AUC of serum CD71 and ACTA alone in the diagnosis of elderly COPD complicated with pulmonary infection was lower than that of their combined diagnosis(Zcombination-CD71=2.826,Zcombination-ACTA=2.726,P＜0.05).The detection rate of Gram negative bacteria in sputum samples of elderly patients with COPD complicated with pulmonary infection was 73.15％.The most common Gram negative bacteria was Acinetobacter baumannii,and the most common Gram positive bacteria was Streptococcus pneumoniae.Conclusion The serum levels of CD71 and ACTA are higher in elderly patients with COPD complicated with pulmonary infection,and the changes in levels are related to the severity of pulmonary infection.The combination of serum CD71 and ACTA can be used to diagnose elderly COPD complicated with pulmonary infection.The pulmonary infections of elderly COPD are mostly caused by Gram negative bacteria.
elderly chronic obstructive pulmonary diseasepulmonary infectionpathogenic bacteriatransferrin receptor 1activin A
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