血清CXCL10水平与社区获得性肺炎严重程度及预后的关系-东南大学学报医学版

血清CXCL10水平与社区获得性肺炎严重程度及预后的关系

单位：成都市金牛区人民医院呼吸内科, 四川成都 610000

关键词：社区获得性肺炎 C-X-C基序趋化因子配体10 CAP疾病严重程度评分预后

分类号：R563.1

出版年·卷·期（页码）：2023·42·第四期（553-559）

摘要：

目的:探究血清C-X-C基序趋化因子配体10(CXCL10)水平与社区获得性肺炎(CAP)严重程度及预后的关系。方法:选择2018年10月至2022年6月本院接收的180例CAP患者为实验组(CAP组),另纳入同期100例健康体检者为对照组。采用ELISA检测血清CXCL10水平,分析CXCL10水平与CAP严重程度和预后的关系;血清CXCL10水平与实验室指标及CAP严重程度评分的相关性分析采用Pearson法;CAP患者预后的影响因素采用Logistic回归进行分析。采用受试者工作特征(ROC)曲线分析血清CXCL10水平对CAP患者严重程度及预后的预测价值。结果:相较于对照组,CAP组患者白细胞、中性粒细胞、中性粒细胞与淋巴细胞比(NLR)、单核细胞比(MON)、血小板与淋巴细胞比(PLR)、白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、CXCL10水平显著升高,淋巴细胞与尿酸水平显著降低(P＜0.05)。随着CAP疾病严重程度的增加,肺炎严重程度指数(PSI)、CURB-65评分、CRB-65评分、SMART-COP评分、CURXO评分中的CXCL10水平逐步上升(P＜0.05)。CAP患者血清CXCL10水平与PLR、IL-1β、TNF-α、PSI、CURB-65评分、CRB-65评分、SMART-COP评分、CURXO评分呈正相关(r值分别为0.550、0.573、0.593、0.649、0.663、0.658、0.514、0.579,均P＜0.05)。ROC结果显示,血清CXCL10水平预测CAP患者严重程度及不良预后曲线下面积(AUC)分别为0.835、0.816。结论:CAP患者血清中CXCL10水平升高,随着CAP疾病严重程度的加重,CAP疾病严重程度评分逐步上升,血清CXCL10对CAP疾病的严重程度以及预后有一定的预测价值。

Objective: To study on the relationship between serum C-X-C motif chemokine ligand 10(CXCL10) levels and the severity and prognosis of community acquired pneumonia(CAP). Methods: A total of 180 patients with CAP received in our hospital from October 2018 to June 2022 were selected as an experimental group(CAP group). In addition, 100 health examinees in the same period were included in a control group. Serum CXCL10 level was detected by ELISA, and the relationship between CXCL10 level and the severity and prognosis of CAP was analyzed; the correlation analysis of serum CXCL10 level with laboratory indexes and CAP severity score was performed by Pearson method; the influencing factors of the prognosis of CAP patients were analyzed by logistic regression. ROC curve was used to analyze the predictive value of serum CXCL10 level for the severity and prognosis of patients with CAP. Results: Compared with the control group, the leukocytes, neutrophils, NLR, MON, PLR, IL-6, IL-1, TNF, CRP, CXCL10 were obviously increased in the CAP group, while lymphocytes and uric acid were obviously decreased(P<0.05). With the increase of the severity of CAP disease, CXCL10 in PSI, CURB-65, CRB-65, SMART-COP and CURXO increased gradually(P<0.05). The CXCL10 level in the serum of CAP patients was positively correlated with PLR, IL-1, TNF, PSI, CURB-65, SMART-COP, CURXO(r=0.550, 0.573, 0.593, 0.649, 0.663, 0.658, 0.514, 0.579, all P<0.05). ROC results showed that the AUC of serum CXCL10 level in predicting the severity and poor prognosis of CAP patients was 0.835 and 0.816, respectively. Conclusion: The level of CXCL10 in serum of patients with CAP increases. With the increase of the severity of CAP disease, the severity score of CAP disease gradually increases. The serum CXCL10 has a certain predictive value for the severity and prognosis of CAP disease.

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