血清sCD163/sTWEAK比值与老年社区获得性肺炎住院病人不良心血管事件的相关性分析

Correlation between serum sCD163/sTWEAK ratio and adverse cardiovascular events in elderly hospitalized patients with community acquired pneumonia

目的分析可溶性血红蛋白清道夫受体163蛋白(sCD163)/可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)比值与社区获得性肺炎(CAP)住院病人发生不良心血管事件(CVE)的相关性。方法选取本院收治的CAP病人154例为研究对象,根据是否合并CVE分为CVE组及无CVE组。统计所有病人30 d生存情况,并进一步分为死亡组及生存组。采用Logistic多因素回归分析影响CVE发生的相关因素,采用COX回归模型分析CAP病人入院30 d内死亡的影响因素。结果CVE组年龄、白细胞计数、血小板计数、sCD163、sTWEAK及sCD163/sTWEAK以及高血压、冠心病、慢性心力衰竭、慢性肾脏病、意识改变、PSI评分≥Ⅳ级、酸中毒、低白蛋白血症病人比例均高于无CVE组(P<0.05)。多因素Logistic回归分析显示,年龄、慢性心力衰竭、PSI评分及sCD163/sTWEAK是影响CAP住院病人发生CVE的独立危险因素(P<0.05)。死亡组病人血清sCD163/sTWEAK明显高于生存组(P<0.05),且sCD163/sTWEAK≥0.35是CAP病人入院30 d内死亡的独立危险因素。结论随着血清sCD163/sTWEAK升高,CAP病人发生CVE的风险及30 d内病死率增加。

Objective To analyze the association of soluble haemoglobin scavengeRreceptoR(sCD163)/soluble tumoRnecrosis factor-like weak induceRof apoptosis(sTWEAK)ratio with adverse cardiovasculaRevents(CVE)in the elderly hospitalized patients with community acquired pneumonia(CAP).Methods A total of 154 CAP patients admitted to ouRhospital were selected and divided into the CVE group and the non-CVE group.The 30-day survival of all patients was recorded,and the patients were furtheRdivided into the death group and the survival group.Multivariate Logistic regression was used to analyze the related factors affecting the occurrence of CVE.COX regression model was used to analyze the influencing factors of death within 30 days of admission in the elderly patients with CAP.Results The proportion of patients with hypertension,coronary heart disease,chronic heart failure,chronic kidney disease,altered consciousness age,pneumonia severity index(PSI)score≥gradeⅣ,acidosis,hypoalbuminemia and the levels of white blood cell count,platelet count,sCD163,sTWEAK and sCD163/sTWEAK ratio in the CVE group were significantly higheRthan those in the non-CVE group(P<0.05).Multivariate Logistic regression analysis showed that age,chronic heart failure,PSI score and sCD163/sTWEAK ratio were the independent risk factors foRCVE(P<0.05).The serum sCD163/sTWEAK ratio of CAP patients in the death group was higheRthan that in the survival group(P<0.05),and sCD163/sTWEAK ratio≥0.35 was an independent risk factoRfoRdeath within 30 days of admission in the elderly patients with CAP.Conclusions With the increase of serum sCD163/sTWEAK ratio,the risk of CVE and 30-day mortality in CAP patients increase.