老年肺炎外周血活化蛋白C、血栓素B2、可溶性B7-H3水平与病情程度和预后的相关性  

The correlation between the levels of APC,TXB2,and sB7⁃H3 in peripheral blood of elderly patients with pneumonia and the severity and prognosis of the disease

作　　者：郑富霞 苗丽君[2] 黄凤祥[2] 黄仕夫 高增艳 张瑞霞 孟泳 ZHENG Fuxia;MIAO Lijun;HUANG Fengxiang;HUANG Shifu;GAO Zengyan;ZHANG Ruixia;MENG Yong(Department of Pulmonary Diseases,Henan Provincial Hospital of Traditional Chinese Medicine(Second Affiliated Hospital of Henan University of Traditional Chinese Medicine),Zhengzhou 450000,Henan,China;不详)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院)肺病科,河南郑州450000 [2]郑州大学第一附属医院呼吸与危重症医学科,河南郑州450000 [3]广西壮族自治区人民医院重症医学科,广西南宁530000 [4]山东第二医科大学附属医院呼吸与危重症医学科,山东潍坊261200 [5]郑州大学附属郑州中心医院呼吸与危重症医学科,河南郑州450000

出　　处：《实用医学杂志》2025年第7期1056-1061,共6页The Journal of Practical Medicine

基　　金：河南省科技攻关项目(编号:2023ZY3008)。

摘　　要：目的探讨老年肺炎外周血活化蛋白C(APC)、血栓素B2(TXB2)、可溶性B7-H3(sB7-H3)水平与病情程度和预后的相关性。方法选取老年肺炎患者100例作为研究组,另选取同期健康志愿者100例作为对照组。比较两组外周血APC、TXB2、sB7-H3水平。研究组根据英国胸科协会改良肺炎评分(CURB-65评分)判定病情程度,分为低危患者、中危患者和高危患者。比较不同病情程度患者外周血APC、TXB2、sB7-H3水平。Pearson相关性分析外周血APC、TXB2、sB7-H3水平与病情程度的相关性。对研究组随访30 d,根据预后分为预后良好亚组与预后不良亚组,比较研究组不同预后患者临床资料、外周血APC、TXB2、sB7-H3水平。偏相关性分析外周血APC、TXB2、sB7-H3水平与预后的相关性。受试者工作特征(ROC)曲线分析预测价值。结果研究组外周血APC水平低于对照组,TXB2、sB7-H3水平高于对照组(P<0.05);研究组根据CURB-65评分判定病情程度,其中轻度患者33例,中度患者39例,重度患者28例。重度患者外周血APC水平低于中度患者、轻度患者,中度患者低于轻度患者,重度患者TXB2、sB7-H3水平高于中度患者、轻度患者,中度患者高于轻度患者(P<0.05);Pearson相关性分析,外周血APC与CURB-65评分呈负相关,TXB2、sB7-H3与CURB-65评分呈正相关(P<0.05);研究组随访30 d,预后不良亚组外周血APC水平低于预后良好亚组,TXB2、sB7-H3水平高于预后良好亚组(P<0.05);偏相关性分析,外周血APC、TXB2、sB7-H3与预后显著相关(P<0.05);ROC曲线分析,外周血APC、TXB2、sB7-H3预测老年肺炎患者预后的AUC为0.752、0.738、0.761,敏感度为66.67%、76.19%、66.67%,特异度为78.48%、67.09%、78.48%;三者联合预测老年肺炎患者预后的AUC为0.918,敏感度为85.71%,特异度为87.34%,较各指标单独预测价值显著提升(Z=2.207、2.666、2.109,P=0.027、0.008、0.035)。结论老年肺炎外周血APC、TXB2、sB7-H3与病情程度和预后显著Objective To investigate the correlation between the levels of activated protein C(APC),thromboxane B2(TXB2),and soluble B7⁃H3(sB7⁃H3)in the peripheral blood of elderly patients with pneumonia and the severity as well as prognosis of the disease.Methods One hundred elderly pneumonia patients admitted to our hospital from March 2022 to June 2024 were enrolled as the study group,and 100 healthy volunteers during the same period were selected as the control group.The levels of APC,TXB2,and sB7⁃H3 in peripheral blood were com⁃pared between the two groups.Study group patients were further categorized into low⁃risk,medium⁃risk,and high⁃risk subgroups based on the CURB⁃65 score(Confusion,Uremia,Respiratory rate,Blood pressure,Age≥65 years).The levels of APC,TXB2,and sB7⁃H3 in peripheral blood were compared among patients with varying disease severities.Pearson correlation analysis was performed to evaluate the correlation between the levels of APC,TXB2,and sB7⁃H3 in peripheral blood and disease severity.The study group was followed up for 30 days and subsequently divided into good prognosis and poor prognosis subgroups according to their clinical outcomes.Clinical data and peripheral blood levels of APC,TXB2,and sB7⁃H3 were compared between patients with different prognoses.Partial correlation analysis was conducted to assess the relationship between peripheral blood levels of APC,TXB2,and sB7⁃H3 and prognosis.Finally,the predictive value of these biomarkers was evaluated using the Receiver Operating Characteristic(ROC)curve.Results The level of APC in the peripheral blood of the study group was significantly lower than that of the control group,whereas the levels of TXB2 and sB7⁃H3 were significantly higher(P<0.05).The severity of the disease in the study group was assessed using the CURB⁃65 score,which categorized patients into 33 mild cases,39 moderate cases,and 28 severe cases.Severe patients exhibited a lower level of APC in peripheral blood compared to moderate and mild patients.Addit

关 键 词：肺炎 活化蛋白C 血栓素B2 可溶性B7-H3 病情程度 预后 

分 类 号：R563.1[医药卫生—呼吸系统]