血清ApoA-I、CD40L、VCAM-1水平与老年SP患者SHG及预后相关性  

Correlation between the serum ApoA-I,CD40L and VCAM-1 levels and stress hyperglycemia in elderly patients with severe pneumoniaand prognosis

作　　者：沈晶晶 刘建华[1] 曹亮[1] SHEN Jingjing;LIU Jianhua;CAO Liang(Department of Respiratory and Critical Care Unit,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,China,075000)

机构地区：[1]河北北方学院附属第一医院呼吸与危重症监护病房,河北张家口075000

出　　处：《分子诊断与治疗杂志》2021年第4期651-654,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省医学科学研究课题计划(20180915)。

摘　　要：目的研究血清载脂蛋白A-I(ApoA-I)、肿瘤坏死因子相关激活蛋白(CD40L)、血管细胞黏附因子-1(VCAM-1)水平与老年重症肺炎(SP)患者应激性高血糖(SHG)及预后相关性。方法选取本院2018年1月至2020年9月收治的97例SP患者(重症组)和102例普通肺炎患者(普通组)进行研究,另选取同期来本院体检的104例健康人作为对照组。根据是否合并SHG将SP患者分为合并组(n=55)与未合并组(n=42)。根据SP患者28 d生存情况将预后分为存活组(n=67)和死亡组(n=30)。检测各组患者血清ApoA-I、CD40L、VCAM-1水平,并采用Logistic回归模型分析老年SP患者预后影响因素。结果重症组患者血清CD40L、VCAM-1水平明显高于普通组和对照组,血清ApoA-I水平明显低于对照组,差异均有统计学意义(P<0.05)。合并组患者血清ApoA-I显著低于未合并组,血清CD40L、VCAM-1水平和APACHEⅡ评分显著高于未合并组,差异均有统计学意义(P<0.05)。血清ApoA-I水平与APACHEⅡ评分呈负相关(P<0.05),血清CD40L、VCAM-1水平与APACHEⅡ评分呈正相关(P<0.05)。存活组和死亡组患者年龄、性别比较差异无统计学意义(P>0.05),但存活组患者APACHEⅡ评分、血清CD40L、VCAM-1水平均显著高于死亡组,血清ApoA-I显著低于死亡组,差异均有统计学意义(P<0.05)。APACHEⅡ评分、血清ApoA-I、CD40L、VCAM-1均是影响SP患者预后的独立影响因素(P<0.05)。结论血清清ApoA-I、CD40L和VCAM-1在SP患者体内表达异常,且与患者疾病严重程度、SHG的发生密切相关,可作为临床评估SP患者预后的重要指标。Objective To study the correlation of serum apolipoprotein AI(ApoA-I),tumor necrosis factor-related activator protein(CD40 L)and vascular cell adhesion molecule-1(VCAM-1)levels with stress hyperglycemia(SHG)and prognosis in elderly patients with severe pneumonia(SP).Methods The clinical data of 97 patients with SP and 102 patients with common pneumonia who were admitted to the hospital from January 2018 to September 2020 were analyzed retrospectively.Meanwhile,104 healthy individuals were selected as a control group.According to the presence or absence of SHG,patients with SP were divided into the combination group(55 cases)and the non-combination group(42 cases).The levels of serum ApoA-I,CD40 L and VCAM-1 in each group were detected.The influencing factors of prognosis in elderly patients with SP were analyzed by Logistic regression model.Results The levels of serum CD40 L and VCAM-1 in the severe group were significantly higher than those in the common group and the control group,while the level of serum Apo A-I was significantly lower than that in the control group.The differences were statistically significant(P<0.05).The level of serum Apo A-I in the combination group was significantly lower than that in the non-combination group,while the levels of serum CD40 L and VCAM-1,and APACHEⅡscore were significantly higher than those in the non-combination group(P<0.05).The level of serum Apo A-I was negatively correlated with the APACHEⅡscore(P<0.05),and the levels of serum CD40 L and VCAM-1 were positively correlated with the APACHEⅡscore(P<0.05).There was no statistically significant difference in age or gender between the survival group and the death group(P>0.05),but the APACHEⅡscore,serum CD40 L and VCAM-1 levels in the survival group were significantly higher than those in the death group,and the level of serum Apo A-I was significantly lower than that in the death group,the difference was statistically significant(P<0.05).The APACHEⅡscore,serum Apo A-I,CD40 L and VCAM-1 are all independent factors

关 键 词：APOA-I CD40L VCAM-1 应激性高血糖 

分 类 号：R563.1[医药卫生—呼吸系统]