Etiological characteristics of COPD patients with pulmonary infection and the diagnostic value of NLR,MIP-1α and HMGB1
OBJECTIVE To explore the etiological characteristics of chronic obstructive pulmonary disease(COPD)with pulmonary infection(PI)and its association with neutrophil to lymphocyte ratio(NLR),macrophagic inflam-matory protein(MIP)-1α and high mobility group protein 1(HMGB1).METHODS COPD patients who were ad-mitted to Chengdu Third People's Hospital from Mar.2021 to Mar.2023 were randomly included and allocated in-to the PI group with 51 cases and the non-infection group with 83 cases.The etiological characteristics of COPD with PI were analyzed,and the risk factors for PI occurrence in COPD patients were calculated by Logistic analy-sis.The expression levels of NLR,MIP-1α and HMGB1 in peripheral blood of the PI group and the non-infection group were compared.The diagnostic value of NLR,MIP-1α and HMGB1 for COPD with PI were analyzed by the receiver operating characteristic curve(ROC).RESULTS A total of 59 strains of pathogenic bacteria were detected in 51 COPD patients with PI,and the proportion from high to low was Gram-negative bacteria,Gram-positive bacteria and fungi.The risk factors for PI occurrence in COPD patients were diabetes mellitus,long-term usage of glucocorticoids,antimicrobial usage above 14 days,hospitalizing above 14 days,and mechanical ventilation(OR=3.043,2.956,2.583,3.019,2.604,P＜0.05,respectively).The PI group had significantly higher levels of NLR,MIP-1α,and HMGB1 in peripheral blood than the non-infection group(P＜0.05).The area under the re-ceiver operating characteristic curve(AUC)value of the combined detection of NLR,MIP-1α and HMGB1 in the diagnosis of PI in COPD patients was higher than that of single index above(P＜0.05),and the sensitivity and specificity of the combined detection was 94.12％and 80.72％,respectively.CONCLUSIONS The major patho-genic bacteria of PI in COPD patients is Gram-negative bacteria.The occurrence of PI in COPD patients is related to diabetes mellitus,long-term usage of glucocorticoids,antimicrobial usage,length of hospital stay and mechani-cal ventilation.NLR,MIP-1α and HMGB1 are highly expressed in peripheral blood of COPD with PI patients,and combined detection of the three indexes can improve their diagnostic value.
Chronic obstructive pulmonary diseasePulmonary infectionPathogenic bacteriaNeutrophil to lym-phocyte ratioMacrophage inflammatory protein-1αHigh mobility group protein 1Receiver operating character-istic curveDiagnostic valueRisk factor
万方数据
维普
