Correlation Analysis Of SII PNI With Bronchiectasis-Chronic Obstructive Pulmonary Disease Overlap Syndrome

Objective To explore the correlation between systemic immune inflammatory index(SII),prognostic nutritional index(PNI)and bronchiectasis-Chronic obstructive pulmonary disease overlap syndrome(BCOS).The clinical data of patients with COPD in Fuyang People’s Hospital were retrospectively analyzed,the clinical characteristics and risk factors of BCOS were studied,and the correlation between SII,PNI and BCOS was explored,so as to improve the understanding of this disease and provide theoretical support for individualized treatment,so as to achieve the ultimate goal of improving the prognosis and quality of life of these patients.Methods The medical records of 331 patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)admitted to Fuyang People’s Hospital from June 1,2019 to May 31,2020 were retrospectively analyzed.According to the manifestations of HRCT,the patients were divided into chronic obstructive pulmonary disease(COPD)group(n=271)and BCOS group(n=60).The difference of clinical data and test results between the two groups was compared,the risk factors of bronchiectasis in COPD patients were analyzed by binary logistics regression model,and the efficacy of SII and PNI in diagnosing BCOS was evaluated by receiver operating characteristic(ROC)curve.Results There was no significant difference in age,sex,body mass index(BMI)and other general information between the two groups(P > 0.05).PNI,Hb,FEV1%Pred and FEV1/FVC in BCOS group were significantly lower than those in COPD group.Diabetes mellitus,duration of antibiotic use,duration of disease,length of hospital stay,number of acute exacerbations in the past 1 year,total cost,white blood cell count(WBC),C-reactive protein(CRP),SII and fibrinogen(FIB)were all higher than those in COPD group,with statistical significance(P < 0.05).Logisitic regression analysis showed that SII,Pseudomonas aeruginosa and the number of acute exacerbations in the past year were positively correlated with BCOS(OR=1.002,4.261,2.237),which were the risk factors.PNI was negatively correlated with BCOS(OR=0.906),which was the protective factor,and the differences were statistically significant(P < 0.05).ROC curve analysis showed that the best cut-off value,sensitivity and specificity of SII diagnosis of BCOS was 688.866,83.30% and 64.90%,and the best cut-off value,sensitivity and specificity of PNI diagnosis of BCOS was 42.225,76.70% and 63.5%.Conclusion Compared with COPD group,BCOS patients have more severe lung structural damage,worse lung function,higher probability of colonization of potential pathogenic microorganisms by airway mucosa,more severe airway inflammatory response,more complex pathogens,and more difficult clinical treatment.The number of acute exacerbations,SII,PNI and Pseudomonas aeruginosa infection in the past year were independent risk factors for BCOS,among which SII and PNI had certain diagnostic value for BCOS.