S100β对重症肺炎患者预后评估的价值

The Value of S100βin Prognostic Assessment of Patients with Severe Pneumonia

目的:探讨S100β对重症肺炎患者预后的评估价值。方法:以出院作为研究的观察终点,对2021年5月至2023年10月期间中山大学附属第一医院急诊科收治的107例重症肺炎患者的资料进行回顾性分析,根据S100β的血清学浓度分为阴性组和阳性组,根据患者出院存活状态分为存活组及死亡组,用GCS评分评估患者入院时神志,用CURB-65评分、SOFA评分、APACHEⅡ评分、PSI指数评估重症肺炎患者病情严重程度,采用出院时存活情况、机械通气时间(天)、去甲肾上腺素剂量(mg)、CRRT时间(天)评估重症肺炎患者预后。结果:107例重症肺炎患者中S100β阳性组的患者48人(44.9%),阴性患者59人(55.1%)。S100β阳性患者GCS评分低于S100β阴性患者,SOFA评分高于S100β阴性患者。S100β阳性组的患者住院期间机械通气时间、去甲肾上腺素使用剂量、CRRT治疗时长均高于S100β阴性患者。S100β阳性组的患者院内死亡率(62.5%)显著高于S100β阴性患者的(23.7%)。S100β联合SOFA评分及APACHEⅡ评分预测重症肺炎预后时,能辅助原有评分,提高诊断的特异性。结论:重症肺炎患者脑损伤发生率较高,可达44.9%,S100β能反映重症肺炎患者的病情严重程度,是预测重症肺炎患者预后不良的独立危险因素。

Objective:To explore the value of S100βin assessing the prognosis of patients with severe pneumonia.Methods:With hospital discharge as the study's primary endpoint,we conducted a retrospective analysis of data on 107 patients with severe pneumonia admitted to the emergency department of the First Affiliated Hospital of Sun Yat-sen University from May 2021 to October 2023.Patients were categorized into S100β-negative and S100β-positive groups based on their serum S100βlevels,and into survival and non-survival groups based on their discharge outcomes.The Glasgow Coma Scale(GCS)score was used to evaluate the level of consciousness on admission,and the CURB-65 score,Sequential Organ Failure Assessment(SOFA)score,Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ score,and the Pneumonia Severity Index(PSI)were used to assess the severity of the patients'conditions.The prognosis of patients with severe pneumonia was evaluated based on survival status at discharge,duration of mechanical ventilation(days),dose of norepinephrine(mg),and duration of continuous renal replacement therapy(CRRT)(days).Results:Among the 107 patients with severe pneumonia,there were 48(44.9%)in the S100β-positive group and 59(55.1%)in the S100β-negative group.Patients in the S100β-positive group had lower Glasgow Coma Scale(GCS)scores and higher Sequential Organ Failure Assessment(SOFA)scores compared to those in the S100β-negative group.The duration of mechanical ventilation,the dose of norepinephrine used,and the length of continuous renal replacement therapy(CRRT)treatment during hospitalization were all higher in the S100β-positive group than in the S100β-negative group.The in-hospital mortality rate in the S100β-positive group(62.5%)was significantly higher than that in the S100β-negative group(23.7%).The combination of S100βwith SOFA score and APACHE Ⅱ score in predicting the prognosis of severe pneumonia can complement the existing scores and improve the specificity of diagnosis.Conclusion:The incidence of brain injury in patients with severe pneumonia is relatively high,reaching 44.9%.S100βcan reflect the severity of the disease in patients with severe pneumonia and serves as an independent risk factor for predicting an unfavorable prognosis in patients with severe pneumonia.