摘要
目的探讨血清白细胞介素-18(IL-18)、中性粒细胞分化抗原64(CD64)及沉默信息调节因子相关酶3(SIRT3)对重症肺炎患者多器官功能衰竭(MOFE)的预测价值。方法回顾性选取2020年8月至2022年8月新乡医学院第一附属医院收治的300例重症肺炎患者的临床资料,根据有无MOFE发生分为MOFE组90例和非MOFE组210例。比较两组患者的一般资料及血清IL-18、CD64及SIRT3水平,采用Logistic回归分析重症肺炎患者MOFE影响因素;采用受试者工作特征(ROC)曲线评价血清IL-18、CD64及SIRT3水平对重症肺炎患者MOFE发生的预测价值。结果MOFE组患者的年龄、慢阻肺所占比例、CPIS评分、APCHEⅡ评分明显高于非MOFE组,差异均有统计学意义(P<0.05);MOFE组患者的血清IL-18、CD64水平分别为(22.49±5.04)ng/L、(46.83±5.92)%,明显高于非MOFE组(16.46±3.59)ng/L、(39.06±4.26)%,SIRT3水平为(3.98±0.84)pg/mL,明显低于非MOFE组(4.82±1.25)pg/mL,差异均具有统计学意义(P<0.05);经Logistic回归分析结果显示,年龄、合并慢阻肺、血清IL-18、CD64及SIRT3均为重症肺炎患者MOFE发生的影响因素(P<0.05);血清IL-18、CD64及SIRT3水平预测重症肺炎患者MOFE发生的曲线下面积(AUC)分别为0.804、0.807、0.742,三指标联合预测MOFE发生的AUC为0.926,明显高于血清IL-18、CD64及SIRT3单独预测(Z=22.941、20.837、25.963,P<0.001),此时最佳敏感度、特异度分别为78.89%、91.43%。结论重症肺炎患者血清IL-18、CD64水平升高,SIRT3水平下降,均为MOFE发生的重要因素,联合检测三者水平有助于预测重症肺炎患者MOFE的发生。
Objective To explore the predictive value of serum interleukin-18(IL-18),cluster of differentiation 64(CD64),and silencing information regulatory factor-related enzyme 3(SIRT3)for multiple organ failure(MOFE)in patients with severe pneumonia.Methods The clinical data of 300 patients with severe pneumonia admitted to the First Affiliated Hospital of Xinxiang Medical College from August 2020 to August 2022 were retrospectively selected and divided into a MOFE group of 90 patients and a non-MOFE group of 210 patients based on the occurrence of MOFE.The general data and serum levels of IL-18,CD64,and SIRT3 were compared between the two groups,and logistic regression analysis was used to analyze the influencing factors of MOFE in patients with severe pneumonia.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum levels of IL-18,CD64,and SIRT3 for the occurrence of MOFE in patients with severe pneumonia.Results The age,COPD proportion,CPIS score,and AAPCHEⅡscore of patients in the MOFE group were significantly higher than those in the non-MOFE group,and the differences were statistically significant(P<0.05).The levels of serum IL-18 and CD64 in the MOFE group were(22.49±5.04)ng/L and(46.83±5.92)%,respectively,which were significantly higher than(16.46±3.59)ng/L and(39.06±4.26)%in the non-MOFE group,respectively;the level of SIRT3 was(3.98±0.84)pg/mL,which was significantly lower than(4.82±1.25)pg/mL in the non-MOFE group;the differences were statistically significant(P<0.05).Logistic regression analysis showed that age,chronic obstructive pulmonary disease(COPD),serum IL-18,CD64,and SIRT3 were all factors affecting the occurrence of MOFE in patients with severe pneumonia(P<0.05).The area under the curve(AUC)of serum IL-18,CD64,and SIRT3 levels for predicting the occurrence of MOFE in patients with severe pneumonia were 0.804,0.807,and 0.742,respectively,and the AUC of the three indicators in combination for predicting MOFE was 0.926,which was significantly higher th
作者
付君静
李闯
陈胜阳
FU Jun-jing;LU Chuang;CHEN Sheng-yang(Department of Critical Care Medicine,Emergency Intensive Care Ward,Weihui 453100,Henan,CHINA;Department of Critical Care Medicine,Department of Anesthesia and Perioperative Medicine,Weihui 453100,Henan,CHINA;Department of Critical Care Medicine,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,Henan,CHINA)
出处
《海南医学》
CAS
2024年第13期1880-1884,共5页
Hainan Medical Journal
基金
2018年度河南省医学科技攻关计划联合共建项目(编号:2018020351)。
