| 冯 凯,范贤明,欧阳晓莉,赵会君,陈菊屏.不同病情老年社区获得性肺炎患者血清ALB、NT-proBNP、PTX3、SDC4的变化及对预后的影响分析[J].,2023,(1):152-157 |
| 不同病情老年社区获得性肺炎患者血清ALB、NT-proBNP、PTX3、SDC4的变化及对预后的影响分析 |
| Changes in Serum ALB, NT-proBNP, PTX3 and SDC4 in Elderly Patients with Community-Acquired Pneumonia with Different Conditions and Analysis of the Impact on Prognosis |
| 投稿时间：2022-03-28 修订日期：2022-04-24 |
| DOI：10.13241/j.cnki.pmb.2023.01.030 |
| 中文关键词: 老年 社区获得性肺炎 ALB NT-proBNP PTX3 SDC4 预后 |
| 英文关键词: Elderly Community-acquired pneumonia ALB NT-proBNP PTX3 SDC4 Prognosis |
| 基金项目:四川省科学技术厅联合科研专项资金计划资助项目（14ZC0048） |
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| 中文摘要: |
| 摘要 目的：分析不同病情老年社区获得性肺炎（CAP）患者血清白蛋白（ALB）、N末端脑钠肽前体（NT-proBNP）、正五聚蛋白3（PTX3）、多配体蛋白聚糖4（SDC4）的变化并探讨其对患者预后的影响。方法：选取2019年1月～2020年1月西南医科大学附属医院收治的196例老年CAP患者，根据病情严重程度分为重症CAP组80例和非重症CAP组116例，根据入院后28 d存活情况分为死亡组25例和存活组171例。收集患者临床资料，检测血清ALB、NT-proBNP、PTX3、SDC4水平。通过多因素Logistic回归分析老年CAP患者死亡的影响因素，受试者工作特征（ROC）曲线分析血清ALB、NT-proBNP、PTX3、SDC4水平对老年CAP患者死亡风险的预测价值。结果：与非重症CAP组比较，重症CAP组血清ALB、SDC4水平降低，NT-proBNP、PTX3水平升高（P＜0.05）。多因素Logistic回归分析显示，ALB升高、SDC4升高为老年CAP患者死亡的保护因素，呼吸频率加快、CURB-65评分增加、肺炎严重指数（PSI）增加、NT-proBNP升高、PTX3升高为老年CAP患者死亡的危险因素（P＜0.05）。ROC曲线分析显示，血清ALB、NT-proBNP、PTX3、SDC4水平联合预测老年CAP患者死亡的曲线下面积（AUC）大于各指标单独预测。结论：老年CAP患者体内血清ALB、SDC4水平降低，NT-proBNP、PTX3水平升高，血清ALB、NT-proBNP、PTX3、SDC4与患者病情加重和预后有关，具有作为老年CAP患者预后评估指标的潜能。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the changes in serum albumin (ALB), N-terminal pro-brain natriuretic peptide (NT-proBNP), pentraxin 3 (PTX3) and syndecan 4 (SDC4) in elderly patients with community-acquired pneumonia (CAP) with different conditions and to investigate their impact on prognosis. Methods: 196 elderly patients with CAP who were admitted to Affiliated Hospital of Southwest Medical University from January 2019 to January 2020 were selected, and they were divided into the severe CAP group with 80 cases and non-severe CAP group with 116 cases according to the severity of their conditions, and according to the survival status after 28 d, they were divided into the death group with 25 cases and survival group with 171 cases. Clinical data of patients were collected, and serum ALB, NT-proBNP, PTX3 and SDC4 levels were measured. The influencing factors of death in elderly patients with CAP were analyzed by multivariate Logistic regression, and the predictive value of serum ALB, NT-proBNP, PTX3, SDC4 levels on the risk of death in elderly patients with CAP was analyzed by receiver operating characteristic(ROC) curve. Results: Compared with the non-severe CAP group, serum ALB and SDC4 levels in the severe CAP group were decreased, and the NT-proBNP and PTX3 levels were elevated (P<0.05). Multivariate Logistic regression analysis showed that elevated ALB and elevated SDC4 were protective factors for death in elderly patients with CAP, and the increased respiratory rate, increased CURB-65 score, increased pneumonia severity index (PSI), elevated NT-proBNP and elevated PTX3 were risk factors for death in elderly patients with CAP(P<0.05). ROC curve analysis showed that the area under curve (AUC) of serum ALB, NT-proBNP, PTX3 and SDC4 levels combined in predicting the death of elderly patients with CAP was greater than that of each index alone. Conclusion: The serum ALB and SDC4 levels in elderly patients with CAP are decreased, and the NT-proBNP and PTX3 levels are elevated. Serum ALB, NT-proBNP, PTX3 and SDC4 are related to the aggravation of conditions and prognosis of patients, which has the potential to be used as prognostic indicators in elderly patients with CAP. |
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