Objective To explore the changes of serum immune status in elderly patients with pulmonary tuberculosis(PTB)complicated with chronic obstructive pulmonary disease(COPD)and its predictive value for prognosis.Method 314 elderly patients with PTB complicated with COPD diagnosed in Guangzhou Chest Hospital from January 2019 to January 2023 were divided into good prognosis group(n=155)and poor prognosis group(n=159)according to the prognosis of the patients.The general data and serum immune status indexes of the two groups were compared,including immunoglobulin A(IgA),IgG and IgM.Multivariate logistic regression analysis was used to determine the independent risk factors of poor prognosis in elderly PTB patients with COPD,and nomogram prediction model was constructed and evaluated.Result In the poor prognosis group,the proportion of patients with pulmonary heart disease,the levels of interferon-γ,soluble interleukin-2 receptor,D-dimer,fibrinogen,fibrinogen and blood creatinine were higher than the good prognosis group,and the levels of IgA,IgG and IgM were lower than the good prognosis group,which were statistically significant(P＜0.05).The results of multivariate logistic regression analysis showed that decreased serum levels of IgA,IgG and IgM were all risk factors for poor prognosis of patients(P＜0.05).The prediction results of the nomogram prediction model constructed accordingly have some authenticity,but the consistency with the actual results is low(Kappa＜0.40).Conclusion The combined prediction of serum IgA,IgG and IgM is of great value for the prediction of pre-elderly PTB patients with COPD,and the changes of serum IgA,IgG and IgM levels in elderly PTB patients with COPD should be monitored in clinical practice.
关键词
老年肺结核/慢性阻塞性肺疾病/免疫状态/预后/预测价值
Key words
Senile tuberculosis/Chronic obstructive pulmonary disease/Immune status/Prognosis/Predictive value
维普
万方数据