血清CC16、Ang-2水平对重症肺炎患者预后的预测价值  

Prognostic value of serum CC16 and Ang-2 levels on prognosis of patients with severe pneumonia

作　　者：王敏[1] 郝明伟[1] 陈晓明 张琳[1] WANG Min;HAO Mingwei;CHEN Xiaoming;ZHANG Lin(Hefei First People's Hospital,Hefei 230601,China)

机构地区：[1]合肥市第一人民医院,合肥230601

出　　处：《山东医药》2021年第16期11-15,共5页Shandong Medical Journal

基　　金：安徽省科技计划项目(1706c08563);合肥市第六周期医学重点学科建设(重点专科-5)。

摘　　要：目的探讨重症肺炎患者血清克拉拉细胞蛋白16(CC16)、血管生成素-2(Ang-2)水平变化及其对预后的预测价值。方法选择132例重症肺炎患者作为重症肺炎组,选择同期体检健康者100例作为健康对照组。比较两组血清Ang-2、CC16水平。根据重症肺炎患者的预后情况将其分为存活组90例和死亡组42例。比较存活组、死亡组的临床资料及血清Ang-2、CC16水平。分析重症肺炎患者预后的影响因素。采用受试者工作特征(ROC)曲线评估血清Ang-2、CC16对重症肺炎患者预后的预测价值。结果与健康对照组相比,观察组血清Ang-2水平升高,CC16水平下降(P均<0.05)。与存活组相比,死亡组血清Ang-2水平升高,CC16、PaO_(2)、PaO_(2)/FiO_(2)水平下降(P均<0.05)。血清Ang-2水平(OR=1.698,95%CI:1.233~3.185,P<0.01)是重症肺炎患者预后的独立危险因素,CC16水平(OR=0.739,95%CI:0.332~0.957,P<0.01)、PaO_(2)(OR=0.523,95%CI:0.307~0.814,P<0.05)、PaO_(2)/FiO_(2)(OR=0.496,95%CI:0.251~0.794,P<0.05)是重症肺炎患者预后的保护因素。血清Ang-2联合CC16预测重症肺炎患者预后ROC曲线下面积为0.885,敏感度、特异度、约登系数分别为79.23%、82.71%、0.619,明显高于血清Ang-2、CC16单独预测的价值(P均<0.05)。结论重症肺炎患者血清Ang-2水平升高、CC16水平下降,并且与患者不良预后密切相关,血清Ang-2联合CC16检测有助于预测重症肺炎患者预后,在重症肺炎患者预后预测中具有一定临床价值。Objective To investigate the level changes of serum clara-cell protein 16(CC16)and angiopoietin 2(Ang-2)in patients with severe pneumonia and their predictive value on prognosis.Methods A total of 132 patients with severe pneumonia were selected as the severe pneumonia group,and 100 healthy subjects were selected as the healthy control group.The levels of serum Ang-2 and CC16 between the two groups were compared.According to the prognosis of patients with severe pneumonia,they were divided into the survival group(n=90)and death group(n=42).Clinical data and serum levels of Ang-2 and CC16 in the survival group and the death group were compared.We analyzed the factors influencing the prognosis of patients with severe pneumonia.Receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of serum Ang-2 and CC16 on prognosis of patients with severe pneumonia.Results Compared with the healthy control group,the level of serum Ang-2 increased and the level of serum CC16 decreased in the observation group(all P<0.05).Compared with the survival group,the level of serum Ang-2 in the death group increased,while the levels of CC16,PaO_(2)and PaO_(2)/FiO_(2) decreased(all P<0.05).The level of serum Ang-2(OR=1.698,95%CI:1.233-3.185,P<0.01) was an independent risk factor for prognosis of patients with severe pneumonia.CC16 level(OR=0.739,95%CI:0.332-0.957,P<0.01),PaO_(2)level(OR=0.523,95%CI:0.307-0.814,P<0.05)and PaO_(2)/FiO_(2)level(OR=0.496,95%CI:0.496,P<0.01),0.251-0.794,P<0.05)were protective factors for the prognosis of patients with severe pneumonia.The area under the ROC curve of serum Ang-2 combined with serum CC16 in predicting severe pneumonia was 0.885,and the sensitivity,specificity and Youden coefficients were 79.23%,82.71%and 0.619,respectively,which were significantly higher than those of serum Ang-2 and serum CC16 alone(all P<0.05).Conclusions The level of serum Ang-2 is increased,while the level of serum CC16 is decreased in patients with severe pneumonia,which are closely related to th

关 键 词：重症肺炎 克拉拉细胞蛋白16 血管生成素-2 预后诊断 

分 类 号：R563.1[医药卫生—呼吸系统]