SAA,IL-6及sCD14对慢性阻塞性肺疾病合并肺部感染患者预后的预测价值  

Predictive Value of Saa,Il-6,and Scd14 for the Prognosis of Copd Patients with Pulmonary Infection

作　　者：张华[1] 李玉梅[1] 张仕萍 伍静 ZHANG Hua;LI Yumei;ZHANG Shiping;WU Jing(Respiratory Department of Luzhou Traditional Chinese Medicine Hospital,Luzhou,Sichuan 646000,China)

机构地区：[1]泸州市中医医院呼吸内科,四川泸州646000

出　　处：《转化医学杂志》2024年第9期1359-1363,共5页Translational Medicine Journal

基　　金：四川省卫生计生委科技项目(18PJ380)。

摘　　要：目的评估血清淀粉样蛋白A(SAA)、白细胞介素6(IL-6)以及可溶性白细胞分化抗原14(sCD14)对慢性阻塞性肺疾病(COPD)合并肺部感染患者预后的预测效能。方法选取2021年6月至2022年12月于沪州市中医医院确诊COPD合并肺部感染的113例患者,根据患者预后情况分为存活组(n=98)与死亡组(n=15)。收集2组临床资料,采集血液运用免疫荧光层析法(IFA)及酶联免疫吸附试验法(ELISA)检测患者SAA,IL-6及s CD14水平,运用多因素Logistic模型分析影响COPD合并肺部感染患者预后的影响因素,并运用受试者工作特征(ROC)曲线分析SAA,IL-6及s CD14单独与联合预测患者预后的价值。结果死亡组COPD分级、慢性阻塞性肺疾病全球倡议(GOLD)分级均高于存活组(P<0.05);存活组SAA、IL-6、sCD14水平均显著低于死亡组(P<0.05);多因素Logistic分析显示,COPD分级、GOLD分级、SAA、IL-6、s CD14水平均为影响COPD合并肺部感染患者预后的相关因素;SAA、IL-6、sCD14水平联合预测的曲线下面积(AUC)为0.848,敏感度、特异度分别为0.800、0.827,优于单项指标预测价值。结论SAA,IL-6及sCD14可单独预测COPD合并肺部感染患者预后,联合预测价值最高,COPD分级、GOLD分级、SAA、IL-6、s CD14水平均为影响COPD合并肺部感染患者预后的危险因素。Objective To evaluate the predictive efficacy of serum amyloid A(SAA),interleukin-6(IL-6),and soluble cluster of differentiation antigen 14(sCD14)in predicting the prognosis of patients with chronic obstructive pulmonary disease(COPD)complicated by pulmonary infection.Methods One hundred and thirteen COPD patients with pulmonary infection in our hospital from June 2021 to December 2022 were selected,and divided into survival group(n=98)and death group(n=15)according to their prognosis.The clinical data of all patients were collected.Levels of SAA,IL-6 and sCD14 were detected by immunofluorescence assay(IFA)and enzyme-linked immunosorbent assay(ELISA).Factors affecting the prognosis of COPD patients with pulmonary infection were identified using multivariate Logistic regression model,then the value of the separate and combined test of SAA,IL-6 and sCD14 in predicting the prognosis of COPD patients with pulmonary infection was evaluated by plotting receiver operating characteristic(ROC)curve.Results The COPD grade and Global Initiative for Chronic Obstructive Lung Disease(GOLD)classification in death group were higher than those in survival group(P<0.05).Levels of SAA,IL-6 and sCD14 in survival group were significantly lower than those in death group(P<0.05).Multivariate Logistic analysis denoted that COPD grade,GOLD classification,SAA,IL-6 and sCD14 levels were all related factors affecting the prognosis of COPD patients with pulmonary infection.The area under the curve(AUC),sensitivity and specificity of combined test of SAA,IL-6 and sCD14 in the prognosis prediction were 0.848,80.0 and 82.7,which were all better than those of individual markexs.Conclusion SAA,IL-6 and sCD14 are of certain value in predicting the prognosis of COPD patients with pulmonary infection,and the combined test obtains the highest predictive value.Furthermore,COPD grade,GOLD classification,SAA,IL-6,and sCD14 levels are all risk factors affecting the prognosis of COPD patients with pulmonary infection.

关 键 词：血清淀粉样蛋白A 白细胞介素6 可溶性白细胞分化抗原14 慢性阻塞性肺疾病 肺部感染 联合预测 

分 类 号：R563.9[医药卫生—呼吸系统]