Significance of serum inflammatory markers for predicting prognosis in chronic obstructive pulmonary disease

doi:10.3877/cma.j.issn.1674-6902.2026.01.013

Abstract

Abstract:

Objective

To investigate the clinical significance of serum inflammatory markers in predicting the prognosis of chronic obstructive pulmonary disease (COPD).

Methods

A total of 76 COPD patients admitted to our hospital from May 2022 to December 2024 were selected as subjects. According to the severity and prognosis of the disease, the patients were divided into an observation group 30 cases and a control group 46 cases. General data and levels of serum inflammatory markers were compared between the two groups. Multivariate logistic regression was used to screen prognostic factors, and receiver operating characteristic (ROC) curves were plotted to validate the predictive value of relevant factors.

Results

In the observation group, there were 2 cases (6.67%) of mild Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, modified British Medical Research Council dyspnea questionnaire (mMRC) score (2.04±0.42), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score (16.32±2.15), procalcitonin (PCT) (1.04±0.25), neutrophil-to-lymphocyte ratio (NLR) (5.81±1.03), and blood eosinophil (EOS) count (1.45±0.44), which were significantly higher than those in the control group: 13 cases (28.26%) of mild GOLD classification, mMRC score (1.79±0.35), APACHE Ⅱ score (14.51±2.07), PCT (0.79±0.21), NLR (4.64±1.17), and EOS (1.01±0.31) (P<0.05). Multivariate logistic regression analysis showed that APACHE Ⅱ score (OR=1.991, 95%CI: 1.156~3.427), PCT (OR=4.871, 95%CI: 1.260~18.826), NLR (OR=6.032, 95%CI: 1.848~19.688), and EOS (OR=4.498, 95%CI: 1.445~13.998) were independent risk factors for poor prognosis. Pearson correlation analysis revealed that PCT, NLR, and EOS were positively correlated with APACHE Ⅱ score (r=0.838, 0.906, 0.839, 0.851, respectively) (P<0.05). ROC curve analysis showed that the combined prediction of PCT, NLR, and EOS achieved an AUC of 0.909, which was higher than that of any single marker.

Conclusion

The combined prediction of serum inflammatory markers such as PCT, NLR, and EOS holds clinical significance for assessing the prognosis of COPD.

Key words: Serum inflammatory markers, Chronic obstructive pulmonary disease, Clinical significance, Prognosis

Licheng Zhao, Qian Sun, Jin Shi, Yuanyuan Wang, Yinping Du, Guohua Dong, Linying Jia, Ziyi Zhou, Xueting Hu. Significance of serum inflammatory markers for predicting prognosis in chronic obstructive pulmonary disease[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2026, 19(01): 83-88.

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References 33

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临床资料	观察组(n＝30)	对照组(n＝46)	t/χ²/Z值	P值
吸烟史[n(%)]	16(53.33)	21(45.65)	0.429	0.513
高血压[n(%)]	14(46.47)	18(39.13)	0.423	0.515
糖尿病[n(%)]	7(23.33)	10(21.74)	0.027	0.871
冠心病[n(%)]	5(16.67)	6(13.04)	0.193	0.661
呼吸机使用[n(%)]	9(30.00)	12(26.09)	0.139	0.709
疾病分期[n(%)]			0.806	0.369
急性加重期	10(33.33)	11(23.91)
慢性稳定期	20(66.67)	35(76.09)
FEV₁%pred[%, (±s)]	59.12±5.74	60.58±4.29	1.193	0.239
FEV₁/FVC[%, (±s)]	66.91±4.67	54.04±4.23	1.770	0.082
PaO₂[mmHg, (±s)]	64.26±5.87	66.27±5.55	1.491	0.141
PaCO₂[mmHg, (±s)]	58.48±5.89	60.26±6.45	1.240	0.219
GOLD分级[n(%)]			6.747	0.080
轻度	2(6.67)	13(28.26)
中度	21(70.00)	27(58.70)
重度	6(20.00)	6(13.04)
极重度	1(3.33)	0(0.00)
mMRC评分(±s)	2.04±0.42	1.79±0.35	2.705	0.009
APACHEⅡ评分[分，(±s)]	16.32±2.15	14.51±2.07	3.640	0.001

临床资料	观察组(n＝30)	对照组(n＝46)	t/χ²/Z值	P值
吸烟史[n(%)]	16(53.33)	21(45.65)	0.429	0.513
高血压[n(%)]	14(46.47)	18(39.13)	0.423	0.515
糖尿病[n(%)]	7(23.33)	10(21.74)	0.027	0.871
冠心病[n(%)]	5(16.67)	6(13.04)	0.193	0.661
呼吸机使用[n(%)]	9(30.00)	12(26.09)	0.139	0.709
疾病分期[n(%)]			0.806	0.369
急性加重期	10(33.33)	11(23.91)
慢性稳定期	20(66.67)	35(76.09)
FEV₁%pred[%, (±s)]	59.12±5.74	60.58±4.29	1.193	0.239
FEV₁/FVC[%, (±s)]	66.91±4.67	54.04±4.23	1.770	0.082
PaO₂[mmHg, (±s)]	64.26±5.87	66.27±5.55	1.491	0.141
PaCO₂[mmHg, (±s)]	58.48±5.89	60.26±6.45	1.240	0.219
GOLD分级[n(%)]			6.747	0.080
轻度	2(6.67)	13(28.26)
中度	21(70.00)	27(58.70)
重度	6(20.00)	6(13.04)
极重度	1(3.33)	0(0.00)
mMRC评分(±s)	2.04±0.42	1.79±0.35	2.705	0.009
APACHEⅡ评分[分，(±s)]	16.32±2.15	14.51±2.07	3.640	0.001

炎症标志物	观察组(n＝30)	对照组(n＝46)	t值	P值
TNF-α(pg/ml)	22.41±1.78	21.63±2.21	1.695	0.095
IL-6(pg/ml)	25.19±7.45	18.65±5.32	4.165	0.000
IFN-γ(pg/ml)	16.87±4.51	15.94±4.65	0.868	0.389
CRP(mg/L)	10.21±1.59	9.52±1.64	1.826	0.073
PCT(ng/ml)	1.04±0.25	0.79±0.21	4.533	0.000
SAA(mg/L)	21.34±3.57	19.97±3.68	1.615	0.111
ESR(mm/1 h)	14.15±2.23	13.87±2.15	0.543	0.589
WBC(×10⁹/L)	8.24±1.42	7.55±1.69	1.919	0.059
NLR	5.81±1.03	4.64±1.17	4.585	0.000
EOS(×10⁹/L)	1.45±0.44	1.01±0.31	4.761	0.000

炎症标志物	观察组(n＝30)	对照组(n＝46)	t值	P值
TNF-α(pg/ml)	22.41±1.78	21.63±2.21	1.695	0.095
IL-6(pg/ml)	25.19±7.45	18.65±5.32	4.165	0.000
IFN-γ(pg/ml)	16.87±4.51	15.94±4.65	0.868	0.389
CRP(mg/L)	10.21±1.59	9.52±1.64	1.826	0.073
PCT(ng/ml)	1.04±0.25	0.79±0.21	4.533	0.000
SAA(mg/L)	21.34±3.57	19.97±3.68	1.615	0.111
ESR(mm/1 h)	14.15±2.23	13.87±2.15	0.543	0.589
WBC(×10⁹/L)	8.24±1.42	7.55±1.69	1.919	0.059
NLR	5.81±1.03	4.64±1.17	4.585	0.000
EOS(×10⁹/L)	1.45±0.44	1.01±0.31	4.761	0.000

自变量	β	标准误	Wald	P值	OR	95%CI
自变量	β	标准误	Wald	P值	OR	下限	上限
mMRC评分	1.583	1.452	1.189	0.276	0.205	0.012	3.535
APACHEⅡ评分	0.688	0.277	6.171	0.013	1.991	1.156	3.427
IL-6	0.088	0.063	1.925	0.165	1.092	0.964	1.237
PCT	1.583	0.690	5.270	0.022	4.871	1.260	18.826
NLR	1.797	0.604	8.865	0.003	6.032	1.848	19.688
EOS	1.504	0.579	6.740	0.009	4.498	1.445	13.998
常量	29.563	8.199	13.002	0.000	0.000

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