血清Ang-2与CC 16检测用于重症社区获得性肺炎预后预测临床价值探讨

Clinical value of serum Ang-2 and CC 16 in predicting prognosis of severe community-acquired pneumonia

目的探讨血清血管生成素(Ang-2)与裸鼠克拉拉细胞蛋白(CC16)检测用于重症社区获得性肺炎预后预测临床价值。方法纳入2016年1月至2022年1月商丘市第一人民医院收治重症社区获得性肺炎患者共264例,根据预后情况分组,其中存活组180例,死亡组84例;比较两组一般资料及实验室检查资料,采用Logistic回归模型评价重症社区获得性肺炎预后独立影响因素,描绘受试者工作特征(ROC)曲线评价独立影响因素的指标用于重症社区获得性肺炎预后预测临床效能。结果存活组动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))及CC16水平分别为(54.61±4.15)mmHg、(99.37±18.06)、(12.07±2.09)μmol/L,均高于死亡组[(51.08±2.90)mmHg、(86.60±14.12)、(9.30±1.12)μmol/L](t=7.982、6.244、14.004,P均<0.001);存活组血清Ang-2水平为(12.37±2.94)μmol/L,低于死亡组[(15.32±3.70)μmol/L](t=6.420,P<0.001)。Logistic回归模型多因素分析结果显示,PaO_(2)、PaO_(2)/FiO_(2)、血清Ang-2及CC16水平均是重症社区获得性肺炎预后独立影响因素(O^R=0.75,95%CI:0.66~0.86,P<0.001;O^R=0.96,95%CI:0.94~0.99,P<0.001;O^R=1.42,95%CI:1.23~1.62,P<0.001;O^R=0.96,95%CI:0.94~0.99,P<0.001);ROC曲线分析结果显示,血清Ang-2、血清CC16、PaO_(2)、PaO_(2)/FiO_(2)、Logistic模型P值用于重症社区获得性肺炎预后预测,约登指数分别为64.05%、44.44%、45.32%、36.19%、81.75%。结论血清Ang-2与CC16用于重症社区获得性肺炎预后预测具有良好效能。

【Objective】To investigate the clinical value of serum angiopoietin-2(Ang-2)and Clara cell protein 16(CC16)in predicting prognosis of severe community-acquired pneumonia.【Methods】Totally 264 patients with severe community-acquired pneumonia were prospectively chosen in the period from January 2016 to January 2022 in our hospital.All patients were grouped according to the prognosis into survival group(180 cases)and died group(84 cases).The general data and laboratory data were compared between 2 groups.Logistic regression model was used to evaluate the independent prognostic factors of severe community-acquired pneumonia and receiver operating characteristic(ROC)curve was described to evaluate the clinical efficacy of independent influencing factors in predicting the prognosis of severe community-acquired pneumonia.【Results】The levels of arterial partial oxygen pressure(PaO_(2)),PaO_(2)/fraction of inspired oxygen(FiO_(2))and CC16 in survival group(54.61±4.15 mmHg,99.37±18.06 and 12.07±2.09μmol/L)were significantly higher than death group(51.08±2.90 mmHg,86.60±14.12,9.30±1.12μmol/L)(t=7.982,6.244,14.004,all P<0.001).The level of serum Ang-2 in survival group(12.37±2.94μmol/L)was significantly lower than death group(15.32±3.70μmol/L)(t=6.420,P<0.001).Logistic regression model showed that PaO_(2),PaO_(2)/FiO_(2),serum Ang-2 and C C 16 were independent prognostic factors of severe community-acquired pneumonia(O^R=0.75,95%CI:0.66-0.86,P<0.001;O^R=0.96,95%CI:0.94-0.99,P<0.001;O^R=1.42,95%CI:1.23-1.62,P<0.001;O^R=0.96,95%CI:0.94-0.99,P<0.001).ROC curve analysis results showed that P values of serum Ang-2,serum CC 16,PaO_(2),PaO_(2)/FiO_(2)and Logistic models were used to predict the prognosis of severe community-acquired pneumonia,and the Yodon index was 64.05%,44.44%,45.32%,36.19%and 81.75%respectively.【Conclusion】Serum Ang-2 and CC 16 has satisfactory prognostic efficacy for severe community-acquired pneumonia.