老年COPD伴肺部感染患者外周血细胞形态学变化及其对预后的预测价值

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Abstract Objective To investigate the morphological changes of peripheral blood cells in elderly patients with chronic obstructive pulmonary disease (COPD) and pulmonary infection and its prognostic value. Methods 140 patients with COPD and pulmonary infection admitted to our hospital from January 2020 to October 2022 were selected. Peripheral blood cell morphology, lung function [Percentage of forced expiratory volume in the 1s to the expected value (FEV1%pred), forced expiratory volume in the 1s/forced vital capacity (FEV1/FVC) ] and infection-related inflammatory factors [serum C-reactive protein (CRP), touchglobin (HPT), soluble leukocyte differentiation antigen 14(sCD14), and membranin A1(ANXA1) ] were detected on the day after admission. After 30 days of follow-up, the patients were divided into survival group (n=121) and death group (n=19) according to prognosis. Peripheral blood cell morphological examination results (abnormal white blood cell morphology, red blood cell morphology and platelet count) and peripheral blood infection-related inflammatory factors were compared between the two groups, and peripheral blood cell morphology and infection-related inflammatory factors were compared in patients with different COPD grades. The correlation of peripheral blood cell morphology with lung function and infection-related inflammatory factors was analyzed, and the prognostic value of peripheral blood cell morphology in elderly patients with COPD and pulmonary infection was analyzed. Results The comparison of abnormal rates of white blood cell morphology and red blood cell morphology between the survival group and the death group showed that the survival group was lower than the death group; The comparison of FEV1% pred, FEV1/FVC, CRP, sCD14, ANXA1, and HPT between the survival group and the death group showed that the levels of FEV1% pred, FEV1/FVC in the survival group were higher than those in the death group, while the levels of CRP, sCD14, ANXA1, and HPT were lower than those in the death group; The difference in the rates of abnormal white blood cell morphology and abnormal red blood cell morphology among COPD grade I, II, and III patients is statistically significant; Comparison of FEV1% pred, FEV1/FVC, CRP, sCD14, ANXA1, and HPT levels in COPD grade I, II, and III patients; the FEV1%pred and FEV1/FVC levels of patients with COPD grade I were higher than those of patients with COPD grades II and III, while the CRP, sCD14, ANXA1, and HPT levels of patients with COPD grade I were lower than those of patients with COPD grades II and III. The abnormal morphology of white blood cells was negatively correlated with FEV1%pred (rs=-0.629, P<0.05) and FEV1/FVC (rs=-0.723, P<0.05), while the abnormal morphology of red blood cells was positively correlated with CRP level (rs=0.594, P<0.05), sCD14 level (rs=0.621, P<0.05), ANXA1 level (rs=0.638, P<0.05), and HPT level (rs=0.680, P<0.05); the AUC of the combined prediction of abnormal morphology of white blood cells and red blood cells was the largest, with an AUC of 0.873(95%CI: 0.806-0.923), a sensitivity of 89.47%, and a specificity of 85.12%. Conclusion Abnormal morphological changes of peripheral blood cells are related to pulmonary function and infection in elderly patients with COPD and pulmonary infection, and have high prognostic value for patients.

Key words： chronic obstructive pulmonary disease lung infection blood cell morphology COPD classification prognosis

Received: 27 July 2023

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	ZHANG Chunmei
	SONG Jie
	WANG Jinxiang

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ZHANG Chunmei,SONG Jie,WANG Jinxiang. Morphological changes of peripheral blood cells in elderly patients with COPD and pulmonary infection and their prognostic value[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2024, 21(2): 51-55.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2024/V21/I2/51

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