急症重症肺炎患者降钙素原清除率、乳酸清除率、白细胞介素-23、中性粒细胞分化抗原64变化及与近期预后的关系  

Analysis of changes in procalcitonin clearance,lactate clearance,interleukin-23 andcluster of differentiation 64 in patients with acute severe pneumonia and their relationship with short-term prognosis

作　　者：陈妮 金鲜珍[1] 赵磊 CHEN Ni;JIN Xian-zhen;ZHAO Lei(The First Affiliated Hospital,Xi'an Jiaotong University,Xi'an 710065,China;Xi'an Honghui Hospital,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710065 [2]西安市红会医院,陕西西安710061

出　　处：《实用医院临床杂志》2025年第2期83-87,共5页Practical Journal of Clinical Medicine

基　　金：陕西省重点研发计划项目(编号:2022SF-423)。

摘　　要：目的分析急症重症肺炎患者降钙素原清除率(PCT-C)、乳酸清除率(LCR)、白细胞介素-23(IL-23)、中性粒细胞分化抗原64(CD64)变化及与近期预后的关系。方法选取2019年1月至2023年10月我院收治的150例急症重症肺炎患者纳入观察组,同期于我院接受治疗的150例非重症肺炎患者纳入对照组,收集患者PCT-C、LCR、IL-23、CD64指标水平并比较,采用成人社区获得性肺炎严重性(PSI)评分评估急症重症肺炎患者预后情况,分析上述指标与急症重症肺炎患者预后的关系。结果观察组PCT-C、LCR水平均低于对照组,IL-23、CD64水平均高于对照组(P<0.05)。经PSI评分评估,PSI评分≤90分的98例纳入预后良好组,PSI评分>90分的52例纳入预后不佳组,不同预后患者急性生理与慢性健康评分(APACHEⅡ)、PCT-C、LCR、IL-23及CD64水平比较差异有统计学意义(P<0.05)。PCT-C、LCR水平与PSI评分呈负相关,IL-23、CD64水平与PSI评分呈正相关(P<0.05)。APACHEⅡ评分、PCT-C、LCR、IL-23及CD64水平均为急症重症肺炎患者预后的影响因素(P<0.05)。结论急症重症肺炎患者的PCT-C、LCR、IL-23及CD64水平均出现显著变化,且上述指标水平与急症重症肺炎患者近期预后密切相关。Objective To analyze the changes of procalcitonin(PCT)clearance(PCT-C),lactate clearance(LCR),interleukin-23(IL-23)and cluster of differentiation 64(CD64)in patients with acute severe pneumonia and their relationship with shortterm prognosis.Methods One hundred and fifty patients with acute severe pneumonia admitted to our hospitals from January 2019 to October 2023 were selected as an observation group.Other 150 patients with non-severe pneumonia treated in our hospitals during the same period were selected as a control group.PCT-C,LCR,IL-23,and CD64 were detected and compared between the two groups.The pneumonia severity index(PSI)score was used to evaluate the prognosis of patients with acute severe pneumonia.The relationship between above indicators and prognosis of patients with acute severe pneumonia was analyzed.Results The levels of PCT-C and LCR in the observation group were lower while the levels of IL-23 and CD64 were higher in the observation group than those in the control group(P<0.05).According to PSI score,98 patients with PSI score of 90 or lower were included in a good prognosis group,and 52 patients with PSI score higher than 90 were included in a poor prognosis group.There were statistically significant differences in the Acute Physiology and Chronic Health Evaluation(APACHE)II score,and the levels of PCT-C,LCR,IL-23,and CD64 between the good and the poor prognosis groups(P<0.05).Pearson correlation analysis found that PCT-C and LCR were negatively correlated with PSI score while IL-23 and CD64 levels were positively correlated with PSI score(P<0.05).Multivariate logistic regression analysis found that APACHE II score,and the levels of PCT-C,LCR,IL-23,and CD64 were prognostic factors in patients with acute severe pneumonia(P<0.05).Conclusions There are significant changes of the levels of PCT-C,LCR,IL-23,and CD64 in patients with acute severe pneumonia.These indicators are closely related to the short-term prognosis of the patients.

关 键 词：急症重症肺炎 降钙素原清除率 乳酸清除率 白细胞介素-23 中性粒细胞分化抗原64 预后 

分 类 号：R563.1[医药卫生—呼吸系统]