血清嗜酸性粒细胞联合总免疫球蛋白E水平检测对老年慢性阻塞性肺疾病患者预后的预测价值

Predictive value of serum eosinophil combined with total immunoglobulin E level detection for the prognosis of elderly patients with chronic obstructive pulmonary disease

中文关键词: 老年    肺疾病,慢性阻塞性    嗜酸细胞    免疫球蛋白E    预后

英文关键词: elderly  pulmonary disease  chronic obstructive  eosinophils  immunoglobulin E  prognosis

中文摘要:

      目的 评价血清嗜酸性粒细胞（EOS）联合总免疫球蛋白E（IgE）水平检测对老年慢性阻塞性肺疾病（COPD）患者预后的预测价值。方法 回顾性分析2021年3月至2024年3月宜宾市第二人民医院确诊的100例老年COPD住院患者。以患者1年后的临床结局分为预后良好组（n=65）和预后不良组（n=35）。比较2组患者基本资料；采用Logistic回归分析老年COPD患者预后不良的影响因素，受试者操作特征（ROC）曲线对其预测价值进行分析。结果 2组患者慢性阻塞性肺疾病全球倡议（GOLD）分级（Ⅲ/Ⅳ）构成比差异有统计学意义（P<0.05）。与预后良好组相比，预后不良组第1秒用力呼气容积（FEV₁）与用力肺活量比值、FEV₁占预计值百分比较低，血清EOS、总IgE水平较高（P<0.001）。Logistic回归显示，GOLD分级（Ⅲ/Ⅳ）、血清EOS和总IgE水平升高是老年COPD患者发生预后不良的影响因素（P<0.05）。ROC曲线显示，GOLD分级（Ⅲ/Ⅳ）、血清EOS和总IgE水平三者联合检测的预测效能最佳，其曲线下面积达到0.908,敏感度为68.57%,特异度为93.85%。结论 在GOLD分级基础上，血清EOS联合总IgE水平检测可能有助于预测老年COPD患者急性加重风险。

英文摘要:

      Objective To explore the predictive value of combined detection of serum eosinophils(EOS)and total immunoglobulin E levels for the prognosis of elderly patients with chronic obstructive pulmonary disease(COPD).Methods A retrospective analysis was conducted on 100 elderly inpatients with COPD diagnosed in Yibin Second People′s Hospital from March 2021 to March 2024.The patients were divided into the good prognosis group(n=65)and the poor prognosis group(n=35)based on their clinical outcomes one year later.Compare the basic information of the two groups of patients;Logistic regression was used to analyze the influencing factors of poor prognosis in elderly patients with COPD,and the predictive value was analyzed by the receiver operating characteristic(ROC)curve.Results There was a statistically significant difference in the composition ratio of the global initiative for chronic obstructive pulmonary disease(GOLD)classification(Ⅲ/Ⅳ)between the two groups of patients(P<0.05).Compared with the good prognosis group,the poor prognosis group had lower forced expiratory volume in one second(FEV1)/forced vital capacity and FEV1%pred,and higher levels of serum EOS and total IgE(P<0.001).Logistic regression showed that GOLD grade(Ⅲ/Ⅳ),elevated serum EOS and elevated total IgE level were the influencing factors for poor prognosis in elderly patients with COPD(P<0.05).The ROC curve shows that the combined detection of GOLD grade(Ⅲ/Ⅳ),serum EOS and total IgE levels has the best predictive efficacy,with an area under the curve reaching 0.908,a sensitivity of 68.57%and a specificity of 93.85%.Conclusion Based on the GOLD classification,the combined detection of serum EOS and total IgE levels may help predict the risk of acute exacerbation in elderly patients with COPD.