心力衰竭合并肺炎患者血清sCD14、sCD163水平与病情严重程度的相关性分析

Correlation among levels of serum sCD14,sCD163 and severity of heart failure(HF)complicated by pneumonia

目的探究心力衰竭(心衰)合并肺炎患者血清可溶性分化簇14(sCD14)、可溶性分化簇163(sCD163)水平与病情严重程度的相关性。方法选取2018年2月至2019年2月于河南科技大学第一附属医院心血管内科收治的心衰合并肺炎患者173例作为观察组,按照心衰发生发展的不同阶段分为轻度组(70例)、中度组(65例)和重度组(38例)三组,另选取我院同期健康体检者50例为对照组。收集受试者心率(HR)、收缩压(SBP)、舒张压(DBP)和白细胞计数(WBC)等资料。采用酶联免疫吸附(ELISA)法检测受试者血清中sCD14、sCD163、脑钠肽(BNP)的水平,全自动生化分析仪检测C反应蛋白(CRP)、降钙素原(PCT)的水平。Pearson法分析sCD14、sCD163与PCT、CRP、BNP的关系。受试者工作特征曲线(ROC)分析sCD14、sCD163对重度心衰合并肺炎患者的预测效能。结果与对照组相比,观察组患者的HR、SBP、DBP、WBC、PCT、CRP、BNP、sCD14、sCD163水平均明显升高(P<0.05)。sCD14、sCD163水平随心衰合并肺炎严重程度增加而升高(P<0.05),与PCT、CRP、BNP均呈正相关(P<0.05)。血清sCD14、sCD163和联合检测对重度心衰合并肺炎患者的诊断曲线下面积分别为0.877、0.887、0.915。结论血清sCD14、sCD163表达水平与心衰合并肺炎疾病严重程度密切相关。

Objective To discuss the correlation among levels of serum soluble cluster of differentiation 14(sCD14),soluble cluster of differentiation 163(sCD163)and severity of heart failure(HF)complicated by pneumonia.Methods The patients with HF complicated by pneumonia(n=173)were chosen into observation group from Department of Cardiovascular Medicine in the First Affiliated Hospital of Henan University of Science and Technology from Feb.2018 to Feb.2019,and according to HF development stages,divided into mild group(n=70),moderate group(n=65)and severe group(n=38).At the same time the healthy controls were chosen into control group(n=50)from the same hospital.The materials of heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),white blood cell count(WBC)were collected from all groups.The levels of sCD14,sCD163 and brain natriuretic peptide(BNP)were detected by using ELISA,and levels of C-reactive protein(CRP)and procalcitonin(PCT)were detected by using automatic biochemical analyzer.The relationship among sCD14,sCD163,PCT,CRP and BNP was detected by using Pearson method.The predictive efficacy of sCD14 and sCD163 to the patients with severe HF complicated by pneumonia was analyzed by using ROC curve.Results Compared with control group,the levels of HR,SBP,DBP,WBC,PCT,CRP,BNP,sCD14 and sCD163 all increased in observation group(P<0.05).The levels of sCD14 and sCD163 increased as the severity of HF+pneumonia increased(P<0.05),and positively correlated to levels of PCT,CRP and BNP(P<0.05).The area under ROC curve of sCD14 was 0.877,that of sCD163 was 0.887,and that of sCD14 combined with sCD163 was 0.915.Conclusion The levels of serum sCD14 and sCD163 are closely correlated to the severity of HF complicated by pneumonia.