重症肺炎患者SAA/CRP、活化蛋白C、CD64对病情转归的预测价值  

Predictive value of SAA/CRP,activated protein C and CD64 for the outcome of patients with severe pneumonia

作　　者：冯琳琳[1] 姚鲁肃 FENG Linlin;YAO Lusu(Department of Respiratory Medicine,Brain Hospital,Liaocheng People′s Hospital,Liaocheng,Shandong 252000,China)

机构地区：[1]山东省聊城市人民医院脑科医院呼吸内科,山东聊城252000

出　　处：《检验医学与临床》2025年第4期451-456,共6页Laboratory Medicine and Clinic

基　　金：山东省优秀中青年科学家科研奖励基金项目(BS2020SW1379)。

摘　　要：目的观察重症肺炎患者血清淀粉样蛋白A(SAA)/C反应蛋白(CRP)、活化蛋白C(APC)、簇分化抗原64(CD64)变化,并分析3项指标对病情转归的预测价值。方法前瞻性选取2020年10月至2022年10月该院126例重症肺炎患者为研究组,另选取同期82例普通肺炎患者为对照组,所有患者入院时均接受实验室指标检测,对比2组血清SAA/CRP、APC、CD64。研究组入院后实施系统性治疗方案并随访3个月,观察患者病情转归情况,并将其分为转归组与未转归组。对比转归组与未转归组临床资料及血清学指标;采用Logistic回归分析重症肺炎患者病情转归的影响因素;绘制受试者工作特征(ROC)曲线分析三者对患者病情转归的预测价值。结果研究组SAA/CRP、CD64高于对照组(P<0.05),APC水平低于对照组(P<0.05);126例重症肺炎患者中病情转归110例(87.30%),未转归16例(12.70%);未转归组SAA/CRP、CD64高于转归组(P<0.05),APC水平低于转归组(P<0.05);点二列相关分析结果显示,SAA/CRP、CD64与重症肺炎患者病情转归呈负相关(r=-0.329、-0.414,P<0.05),APC水平与重症肺炎患者病情转归呈正相关(r=0.388,P<0.05)。Logistic回归分析结果显示,SAA/CRP、CD64、APC是重症肺炎患者病情转归的影响因素(OR=1.717、1.720、0.668,P<0.05)。ROC曲线分析结果显示,SAA/CRP、APC、CD64预测重症肺炎患者病情转归的曲线下面积(AUC)分别为0.805、0.840、0.851,三者联合预测的AUC(0.957)更大。结论重症肺炎患者SAA/CRP、CD64升高,APC水平降低,三者联合可有效预测患者病情转归情况。Objective To observe changes in serum amyloid A(SAA)/C-reactive protein(CRP),activated protein C(APC)and cluster of differentiation 64(CD64)in patients with severe pneumonia,and to analyze the predictive value of these three indicators for disease outcome.Methods A total of 126 patients with severe pneumonia admitted to the hospital from October 2020 to October 2022 were selected prospectively as the study group,and 82 patients with common pneumonia were selected as the control group.All patients underwent laboratory tests upon admission,and the serum SAA/CRP,APC and CD64 were compared between the two groups.After admission,the study group received a systematic treatment and was followed up for 3 months to observe disease outcomes.The patients were divided into the recovery group and the non-recovery group.Clinical data and serological indicators were compared between the two groups.Logistic regression analysis was performed to identify the factors influencing disease outcomes in patients with severe pneumonia.Receiver operating characteristic(ROC)curve was plotted to assess the predictive value of the three indicators for disease outcomes.Results The SAA/CRP and CD64 in the study group were higher than those in the control group(P<0.05),and the level of APC was lower than that in the control group(P<0.05).Among the 126 patients with severe pneumonia,110 cases(87.30%)had favorable outcomes,while 16 cases(12.70%)did not.The SAA/CRP and CD64 in the non-recovery group were higher than those in the recovery group(P<0.05),and the level of APC was lower than that in the recovery group(P<0.05).Point-biserial correlation analysis revealed that SAA/CRP and CD64 were negatively correlated with disease outcomes in patients with severe pneumonia(r=-0.329,-0.414,P<0.05),while APC level was positively correlated with disease outcomes(r=0.388,P<0.05).Logistic regression analysis indicated that SAA/CRP,CD64 and APC were identified as influencing factors for outcomes in severe pneumonia patients(OR=1.717,1.720,0.668,P<0.05).ROC c

关 键 词：重症肺炎 淀粉样蛋白A C反应蛋白 活化蛋白C 簇分化抗原64 

分 类 号：R563.1[医药卫生—呼吸系统] R446.11[医药卫生—内科学]