血清FOXM1和PD-L1在老年重症肺炎早期诊断及预后评估中的预测价值  

Predictive value of serum FOXM1 and PD-L1 in the early diagnosis and prognosis evaluation of severe pneumonia in the elderly

作　　者：商焕霞 倪为波 席素雅[2] 张明洋 张新[1] 郭立娟 SHANG Huan-xia;NI Wei-bo;XI Su-ya(Department of Respiratory and Critical Care Medicine,Shijiazhuang Hebei 050000,China;Department of Infectious Diseases,Hebei Chest Hospital,Shijiazhuang Hebei 050000,China)

机构地区：[1]河北省胸科医院呼吸与危重症医学科,河北石家庄050000 [2]河北省胸科医院感染性疾病科,河北石家庄050000

出　　处：《临床和实验医学杂志》2023年第24期2608-2612,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省财政厅老年病防治课题(编号:361013)。

摘　　要：目的探究血清叉头盒蛋白M1(FOXM1)和程序性死亡蛋白配体1(PD-L1)在老年重症肺炎(SP)早期诊断及预后评估中的预测价值。方法回顾性选取2021年1月至2023年1月河北省胸科医院收治的老年重症肺炎患者106例为重症肺炎组,选择同期本院收治的老年普通肺炎患者102例为对照组。在出院28 d对重症肺炎组生存状况进行门诊或电话随访,根据其生存状况分为死亡组36例和存活组70例。使用全自动生化分析仪测量C反应蛋白(CRP)、降钙素原、乳酸盐脱氢酶(LDH)的水平,采用酶联免疫吸附试验测定血清FOXM1和PD-L1的表达水平;Pearson法分析血清中FOXM1和PD-L1表达水平的相关性;采用受试者工作特征(ROC)曲线分析血清中FOXM1和PD-L1对老年重症肺炎的诊断及预后预测价值。采用多因素Logistic回归分析分析影响老年重症肺炎患者死亡的因素。结果重症肺炎组血清CRP、降钙素原、LDH、FOXM1和PD-L1水平分别为(82.72±8.61)mg/L、(6.01±0.74)ng/L、(669.21±76.25)U/L、(1.32±0.18)ng/mL、(4.12±0.46)ng/mL,均显著高于对照组[(78.36±7.95)mg/L、(5.02±0.42)ng/L、(625.30±63.48)U/L、(1.13±0.13)ng/mL、(3.52±0.41)ng/mL],差异均有统计学意义(P<0.05)。相关性分析显示,老年重症肺炎患者血清中FOXM1和PD-L1表达水平呈正相关关系(r=0.649,P<0.05)。FOXM1和PD-L1联合诊断老年重症肺炎的曲线下面积(AUC)高于单独诊断的AUC值(P<0.05)。死亡组血清CRP、降钙素原、LDH、FOXM1和PD-L1水平分别为(88.35±9.10)mg/L、(6.42±0.75)ng/L、(754.42±86.31)U/L、(1.54±0.17)ng/mL、(4.75±0.48)ng/mL,均显著高于存活组[(79.82±8.36)mg/L、(5.80±0.73)ng/L、(625.39±71.08)U/L、(1.20±0.18)ng/mL、(3.80±0.45)ng/mL],差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,降钙素原、LDH、FOXM1和PD-L1水平是影响老年重症肺炎患者死亡的因素(P<0.05)。二者联合预测老年重症肺炎患者预后的AUC为0.983,高于FOXM1和PD-L1单独�Objective To explore the predictive value of serum FOXM1 and programmed death ligand-1(PD-L1)in early diagnosis and prognosis assessment of severe pneumonia in elderly patients.Methods A total of 106 elderly patients with severe pneumonia treated in Hebei Chest Hospital from January 2021 to January 2023 were selected as severe infectious pneumonia group,and 102 elderly patients with common pneumonia treated in our hospital during the same period were selected as control group.The survival status of severe infectious pneumonia group was followed up by outpatient or telephone at 28 days after discharge.According to the survival status,severe infectious pneumonia group was divided into death group(36 cases)and survival group(70 cases).The levels of C-reactive protein(CRP),procalcitonin and lactate dehydrogenase(LDH)were measured by automatic biochemical analyzer.The expression levels of serum FOXM1 and PD-L1 were determined by enzyme-linked immunosorbent assay.Pearson method was used to analyze the correlation between FOXM1 and PD-L1 expression levels in serum.The value of serum FOXM1 and PD-L1 in the diagnosis and prognosis of elderly severe infectious pneumonia to was analyzed by receiver operating characteristic(ROC)curve.The factors influencing the death of elderly severe infectious pneumonia patients was analyzed by multiple Logistic regression analysis.Results The levels of serum CRP,procalcitonin,LDH,FOXM1,and PD-L1 in the severe pneumonia group were(82.72±8.61)mg/L,(6.01±0.74)ng/L,(669.21±76.25)U/L,(1.32±0.18)ng/mL,and(4.12±0.46)ng/mL,respectively,which were significantly higher than those in the control group[(78.36±7.95)mg/L,(5.02±0.42)ng/L,(625.30±63.48)U/L,(1.13±0.13)ng/mL,and(3.52±0.41)ng/mL],and the differences were statistically significant(P<0.05).Correlation analysis showed that there was a positive correlation between FOXM1 and PD-L1 expression levels in serum of elderly severe infectious pneumonia patients(r=0.649,P<0.05).The area under the curve(AUC)value of FOXM1 combined with PD-L1 in

关 键 词：老年人 诊断 预后 重症肺炎 叉头盒蛋白M1 程序性死亡蛋白1配体1 

分 类 号：R563.1[医药卫生—呼吸系统]