Clinical diagnosis and prognostic value of serum markers in elderly patients with chronic obstructive pulmonary disease complicated with pulmonary infection

Wang Wanying; Shi Zhan; He Siqi; Wang Zixuan; Wang Baozeng

doi:10.3760/j.issn.1673-4777.2024.07.010

Abstract：Objective To investigate the clinical diagnosis and prognostic value of serum growth arrest specific protein 6(Gas6),plasminogen activator inhibitor-1(PAI-1)and serum cholinesterase(S-ChE)in elderly patients with chronic obstructive pulmonary disease(COPD)complicated with pulmonary infection.Methods A total of 106 COPD patients with pulmonary infection admitted to Beijing Tiantan Hospital,Capital Medical University from January 2021 to January 2023 were selected as the infection group,and 111 COPD patients without pulmonary infection during the same period were included as the non-infection group.According to the prognosis,the patients in the infection group were divided into survival group(83 cases)and death group(23 cases).The serum Gas6,PAI-1 and S-ChE levels were compared between the non-infection group and the infection group.The general data of the survival group and the death group were compared.Receiver operating characteristic curve was used to analyze the predictive value of serum Gas6,PAI-1 and S-ChE for pulmonary infection and death in elderly COPD patients.Multivariate Logistic regression was used to analyze the factors affecting the prognosis of elderly COPD patients with pulmonary infection.Results The levels of serum Gas6 and PAI-1 in the infection group were higher than those in the non-infection group,and the level of S-ChE was lower than that in the non-infection group(all P＜0.001).The results of receiver operating characteristic curve showed that the area under the curve of serum Gas6,PAI-1,S-ChE and their combination in the diagnosis of pulmonary infection was 0.787,0.797,0.782,0.889,respectively.The area under the curve of the combined diagnosis of the three was higher than that of their individual diagnosis(Z=4.527,5.435,4.167;all P＜0.001).The proportions of patients with GOLD grade Ⅲand diabetes mellitus,and the levels of serum Gas6 and PAI-1 in the death group were higher than those in the survival group;the levels of ratio of forced expiratory volume in the first second to percentage of expected value,forced expiratory volume in the first second/forced vital capacity ratio and S-ChE were lower than those in the survival group(all P＜0.05).Multivariate Logistic regression analysis showed that Gas6 and PAI-1 were risk factors for death in elderly patients with COPD complicated with pulmonary infection,and S-ChE was a protective factor(all P＜0.05).The receiver operating characteristic curve showed that the area under the curve of the combined diagnosis of serum Gas6,PAI-1 and S-ChE was higher than that of their individual detection(all P＜0.05).Conclusion The levels of serum Gas6 and PAI-1 are increased and S-ChE is decreased in elderly COPD patients with pulmonary infection,which has certain value in the clinical diagnosis and prognosis evaluation of the disease.