Correlation Study Of Serum PCT And NLR On The Evaluation And Prognosis Of COPD

Objective: To investigate the difference of serum Calcitonin(PCT),neutrophil lymphocyte ratio(NLR)and clinical outcome between patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and those with stable chronic obstructive pulmonary disease(AECOPD);Exploring the correlation between the levels of biomarkers(serum PCT,NLR)and the severity of COPD,as well as adverse prognosis outcomes;By jointly detecting the coexistence of elevated serum PCT and NLR levels,we aim to obtain sensitive and specific indicators for predicting the condition and prognosis of COPD.Method: This study included 120 patients with chronic obstructive pulmonary disease admitted from October 2021 to April 2022(80 in the acute exacerbation phase and 40 in the stable phase).General information and data of the patients were collected,and serum PCT and NLR levels at admission were recorded for both groups of patients.Type II respiratory failure,transfer to RICU,ICU,and death were recorded,and telephone follow-up was conducted within 1 month and 6 months after discharge Re admission and survival within 6 months.Mann Whitney U-test was used to analyze the differences in serum PCT,NLR,condition,and prognosis between two groups of COPD patients.Spearman correlation analysis was used to analyze the correlation between serum PCT,NLR,and COPD condition and prognosis.ROC curve analysis and separate and combined detection of the two indicators were used to predict the prognosis of COPD.Graph Pad Prism9.4.0 statistical software was used for scientific research mapping.result:1.The serum PCT and NLR levels,as well as the proportion of readmission(January)and readmission(June)in patients with acute exacerbation were higher than those in stable phase,with statistically significant differences(P<0.05).The two groups of patients with type II respiratory failure,conversion to respiratory intensive care unit(RICU)or intensive care unit(ICU),and death outcomes were also higher than those of stable stage patients,but the difference was not statistically significant(P>0.05).It indicates that the serum levels of PCT and NLR in patients with acute exacerbation are higher than those in stable and regular periods,and the rate of recurrent hospitalization increases.2.PCT and NLR were significantly positively correlated with type II respiratory failure,RICU,ICU,readmission(1 month),readmission(6 months),and death(r=0.471～0.853,P<0.001;r=0.535～0.717,P<0.001).It is suggested that serum PCT and NLR are positively correlated with the severity of the patient’s condition and prognosis,and can be used as indicators to predict the condition and prognosis of COPD.3.The "combined detection" of PCT and NLR is more sensitive and specific in predicting readmission and death within six months of COPD compared to a single indicator detection,but there is no significant increase in sensitivity and specificity in predicting readmission within one month.The combined test predicted an AUC area of 0.950(P<0.001)for readmission within 1 month,with a specificity of 0.849,a sensitivity of 0.926,and a Yoden index of 0.775.The predicted AUC area for readmission within June is0.952(0.911,0.993)(P<0.001),with a specificity of 0.891,a sensitivity of 0.954,and a Jordan index of0.845.The AUC area predicted to die within June is 0.955(0.894,1.000)(P<0.001),with a specificity of0.954,a sensitivity of 0.917,and a Jordan index of 0.871.The sensitivity and specificity of combined detection in predicting the prognosis of COPD are high,and the area under the ROC curve is higher than that of individual detection.Conclusion: 1.The serum PCT and NLR levels and readmission rate within six months in AECOPD patients were significantly higher than those in stable patients.2.COPD patients with higher average levels of serum PCT and NLR have more severe conditions when hospitalized,and the readmission rate and risk of death within six months have also increased.Serum PCT and NLR can be used as indicators to predict the prognosis of COPD.3.The combined detection of serum PCT and NLR has a higher area under the ROC curve for predicting the prognosis of COPD compared to individual detection.