Predictive value of serum SAA,PGRN,and TLR4 on pulmonary infection in elderly patients with chronic obstructive pulmonary disease
OBJECTIVE To analyze the predictive value and impact of serum amyloid A(SAA),granule protein precursor(PGRN),and Toll like receptor 4(TLR4)on elderly chronic obstructive pulmonary disease complicated with pulmonary infection.METHODS A total of 138 elderly patients with COPD complicated with pulmonary in-fection and 145 elderly patients with COPD without pulmonary infection admitted to the Second Hospital Affiliated to Tianjin Medical University from Feb 2020 to Apr 2023 were enrolled and divided into the infection group and non-infection group.The distribution and drug resistance of pathogens in elderly COPD patients complicated with pulmonary infection were analyzed.The levels of serum SAA,PGRN and TLR4 were compared between the infec-ted group and the non-infected group.The receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of the indexes.RESULTS 156 strains were isolated from 138 elderly COPD patients complicated with pulmonary infection.Among them,gram-negative bacteria accounted for 65.38％,gram-positive bacteria ac-counted for 27.56％,and fungi accounted for 7.05％.Pseudomonas aeruginosa had high drug resistance to trime-thoprim and ampicillin sulbactam,while was sensitive to amikacin.Acinetobacter baumannii was sensitive to ami-kacin;Klebsiella pneumoniae was relatively sensitive to amikacin,and completely sensitive to imipenem and mer-openem.The proportion of drug resistance of Staphylococcus aureus to ampicillin,levofloxacin,and clindamycin were relatively high,with 16,15,and 13 strains,respectively.The proportion of drug resistance of Streptococcus pneumoniae to ampicillin,levofloxacin,and clindamycin were relatively high,with 14,12,and 12 strains,re-spectively.The serum SA A,PGRN and TLR4 levels in the infected group were higher than those in the non-infec-ted group(P＜0.05).The area under the curve(AUC)of serum SAA,PGRN and TLR4 combined detection to predict elderly patients with COPD complicated with pulmonary infection was 0.923,which was higher than that of the individual detection(P＜0.05).CONCLUSION Gram-negative bacteria were the main pathogens in elderly patients with COPD complicated with pulmonary infection.The characteristics of antimicrobial resistance of differ-ent pathogens were different.Serum SAA,PGRN and TLR4 were highly expressed in the patients.Combined de-tection of the three indexes has higher predictive value for elderly patients with COPD complicated with pulmonary infection.
Chronic obstructive pulmonary diseaseOld agePulmonary infectionPathogenic bacteriaDrug re-sistanceSerum amyloid protein AProgranulinToll like receptor 4
NETL
NSTL
万方数据
