摘要
目的:研究老年社区获得性肺炎(CAP)患者血清可溶性尿激酶型纤溶酶原激活物受体(suPAR)、正五聚蛋白3(PTX3)水平与疾病严重程度及死亡率的关系。方法:选取2019年3月至2021年3月我院收治的240例老年CAP患者作为研究对象,包括79例重症CAP(sCAP)患者(为sCAP组)和161例非重症CAP患者(为非sCAP组)。采用酶联免疫吸附法检测血清suPAR和PTX3基线水平,计算CURB-65评分和肺炎严重指数(PSI)评分。随访30 d,记录患者死亡情况。使用受试者工作特征(ROC)曲线评价上述指标对CAP患者疾病严重程度和30 d死亡风险的预测能力。结果:与非sCAP组相比,sCAP组患者血清suPAR和PTX3水平显著升高(P<0.05)。随访30 d,29例患者死亡,死亡患者血清suPAR和PTX3水平高于生存患者(P<0.05)。经Spearman秩相关分析,血清suPAR、PTX3水平均与CURB-65评分、PSI评分呈正相关(P<0.001)。ROC曲线分析显示,血清suPAR、PTX3水平用于诊断sCAP的曲线下面积(AUC)为0.904(0.866~0.942)、0.905(0.868~0.941),预测CAP患者30 d死亡的AUC为0.917(0.866~0.968)、0.936(0.900~0.973)。结论:入院时检测血清suPAR、PTX3水平有助于老年CAP患者的危险分层和预后预测。
Objective:To investigate the relationship between the serum soluble urokinase-type plasminogen activator receptor(suPAR),pentraxin-3(PTX3)and the disease severity and mortality in elderly patients with community-acquired pneumonia(CAP).Methods:From March 2019 to March 2021,240 patients with CAP were selected as study subjects,including 79 patients with severe CAP(sCAP group)and 161 patients with non-severe CAP(non-sCAP group).The levels of serum suPAR and PTX3 were detected by enzyme-linked immunosorbent assay.CURB-65 score and pneumonia severity index(PSI)score were calculated based on clinical and laboratory data.The patients were followed up for 30 days and the cause of patients'death was documented.Receiver operating characteristic(ROC)curve were used to identify the severity of CAP patients and predict the 30-day mortality risk.Results:Compared with non-sCAP group,serum suPAR and PTX3 levels were significantly higher in sCAP group(P<0.05).In addition,after 30 days'follow-up,it was found that 29 patients died and the serum suPAR and PTX3 levels in the dead patients were higher than those in the survivals(P<0.05).Spearman rank correlation coefficient analysis showed that serum suPAR and PTX3 levels were positively correlated with CURB-65 score and PSI score(P<0.001).ROC curve analysis results showed that the area under the curve(AUC)of serum suPAR and PTX3 levels on the diagnosis of sCAP was 0.904(0.866-0.942)and 0.905(0.868-0.941),and AUC of these levels on the prediction of 30 days'death was 0.917(0.866-0.968)and 0.936(0.900-0.973)respectively.Conclusion:Determination of serum suPAR and PTX3 levels at admission is helpful for risk stratification and prognosis prediction in elderly patients with CAP.
作者
付庆萍
黄万秀
FU Qingping;HUANG Wanxiu(Department of Respiratory Medicine, Guang'an People's Hospital, Guang'an 638001, China)
出处
《东南大学学报（医学版）》
CAS
2022年第2期215-221,共7页
Journal of Southeast University(Medical Science Edition)
基金
四川省卫生健康委员会普及应用项目(20PJ310)。
