Objective To explore the clinical significance of detecting neutrophil elastase (NE) in patients with acute exacerbation of bronchiectasis complicated with Pseudomonas aeruginosa (PA) infection. Methods Ninety patients with acute exacerbation of bronchiectasis admitted to our hospital from August 2022 to December 2023 were regarded as the trail group. Based on sputum culture results, patients with concomitant PA infection but with other bacterial infections were identified as the combined group (n=36), while patients without concomitant PA infection were selected as the non-combined group (n=54). In addition, 90 patients who underwent stable bronchodilation outpatient visits in our hospital were regarded as the control group and divided into PA colonization group (n=42) and non-PA colonization group (n=48). The expression levels of serum NE, procalcitonin (PCT) and C-reactive protein (CRP) were detected. Pearson method was applied to analyze the correlation between serum NE level and inflammatory markers in patients with acute exacerbation of bronchiectasis. ROC curve was applied to evaluate the predictive efficacy of serum NE and PCT levels for PA infection in patients with acute exacerbation of bronchiectasis. Results The expression levels of serum NE, PCT, and CRP in the trail group were greatly higher than those in the control group (P<0.05).There were no significant differences in the expression levels of serum NE, PCT and CRP between the PA group and the non-PA group (P>0.05). The serum NE, PCT, and CRP levels in the combined group were greatly higher than those in the non-combined group (P<0.05). The serum NE level in patients with acute exacerbation of tracheal dilation was positively correlated with PCT and CRP levels (P<0.05). The area under the curve (AUC) of serum NE, PCT, CRP, and their combination in predicting PA infection in patients with acute exacerbation of bronchiectasis was 0.856, 0.756, 0.702, and 0.962, respectively. The combination of the three was better than their individual predictions (Z combination - NE=2.399, Z combination - PCT=3.741, Z combination - CRP=4.499, P=0.017, P=0.000, P=0.000), with sensitivity and specificity of 80.56% and 96.30%, respectively. Conclusion Serum NE level is greatly elevated in patients with acute exacerbation of bronchiectasis, and is closely related to inflammatory markers PCT and CRP. The combination of the three has a high predictive power for patients with acute exacerbation of bronchiectasis complicated with PA infection.
Key words
Neutrophil elastase /
Pseudomonas aeruginosa /
Acute exacerbation of bronchiectasis /
Clinical significance
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