摘要
目的 观察重症肺炎患者血清淀粉样蛋白A(SAA)、内毒素、肺表面活性蛋白(SPA)的表达水平,探究三者在重症肺炎诊治中的临床意义。方法 选取2019年1月至2022年12月黄山首康医院收治的102例重症肺炎患者作为研究对象,另选取同期轻症肺炎患者95例,以及同期体检健康人群96名,分别设为重症肺炎组(n=102),轻症肺炎组(n=95)以及对照组(n=96)。比较3组SAA、内毒素、SPA水平,比较重症肺炎组与轻症肺炎组肺炎严重程度(PSI)评分;采用Spearman分析SAA、内毒素和SPA水平与PSI评分的相关性;根据预后情况将重症肺炎组患者分为预后良好组和预后不良组,比较两组SAA、内毒素、SPA水平和PSI评分;分析重症肺炎患者预后的影响因素;分析SAA、内毒素和SPA水平单一及联合检测对重症肺炎预后的评估价值。结果 SAA、内毒素、SPA水平:重症肺炎组>轻症肺炎组>对照组,PSI评分:重症肺炎组>轻症肺炎组,差异均有统计学意义(P<0.05);经Spearman相关性分析,SAA、内毒素、SPA水平与PSI评分均呈正相关(r=0.653、0.682、0.734,P均<0.05);根据预后情况将102例重症肺炎患者分为预后良好组(n=86)和预后不良组(n=16),预后不良组SAA、内毒素、SPA水平和PSI评分均高于预后良好组,差异有统计学意义(P<0.05);Logistic回归分析显示,SAA、内毒素和SPA水平和PSI评分为重症肺炎患者预后不良的独立影响因素(P<0.05);单一SAA、内毒素、SPA及三者联合预测重症肺炎症患者预后的AUC分别为0.712、0.705、0.764、0.957,三者联合的预测价值更高(P<0.05)。结论 SAA、内毒素、SPA水平与患者病情严重程度均呈正相关性,在重症肺炎预后评估中有重要价值。
Objective To investigate the clinical significance of surfactant protein A(SPA),Se⁃rum amyloid A(SAA),endotoxin and surfactant protein A in patients with severe pneumonia.Methods 102 patients with severe pneumonia admitted to Huangshan Shoukang Hospital from January 2019 to December 2022 were selected as the study subjects.Additionally,95 patients with mild pneumonia during the same period and 96 healthy individuals who underwent physical examination during the same period were chosen as the se⁃vere pneumonia group(n=102),mild pneumonia group(n=95)and control group(n=96).The study involved comparing SAA,endotoxin,and SPA levels in 3 groups.Furthermore,a comparison of pneumonia severity in⁃dex(PSI)scores was conducted between the severe pneumonia group and the mild pneumonia group.The corre⁃lation of SAA,endotoxin and SPA levels with PSI scores was analyzed using Spearmans analysis.Patients in the severe pneumonia group were then divided into a good prognosis group and a poor prognosis group based on their prognosis.SAA,endotoxin,SPA levels and PSI scores were compared between the two groups.Factors affecting the prognosis of patients with severe pneumonia were analyzed.and the value of single and combined tests of SAA,endotoxin,and SPA levels in assessing the prognosis of severe pneumonia.Results SAA,endo⁃toxin,and SPA levels were found to be in the following order:severe pneumonia group>mild pneumonia group>control group.The PSI score also followed this trend:severe pneumonia group>mild pneumonia group,the differences were statistically significant(P<0.05).After Spearman's correlation analysis,it was determined that SAA,endotoxin,and SPA levels were positively correlated with PSI scores(r=0.653,0.682,and 0.734,P<0.05).In terms of prognosis,the 102 patients with severe pneumonia were divided into a good prognosis group(n=86)and a poor prognosis group(n=16).The SAA,endotoxin,SPA levels and PSI scores of the poor prognosis group were significantly higher than those of the good prognosis group(P<0.05).Logi
作者
江晨
刘飞
王霄龙
何汉涛
JIANG Chen;LIU Fei;WANG Xiaolong;HE Hantao(Department of Respiratory and Critical Care Medicine,Huangshan Shoukang Hospital,Huangshan,Anhui,China,245100)
出处
《分子诊断与治疗杂志》
2024年第4期670-673,共4页
Journal of Molecular Diagnostics and Therapy
基金
安徽省科技计划项目计划项目(2104H0802026)。
