Th17/Treg、Th1/Th2联合NEWS2评分预测肺炎病情进展效能研究

Study on the Efficacy of Th17/Treg,Th1/Th2 Combined with NEWS2 Score in Predicting the Progression of Pneumonia

目的研究辅助性T淋巴细胞17/调节性T淋巴细胞(Th17/Treg)、辅助性T淋巴细胞1/辅助性T淋巴细胞2(Th1/Th2)联合国家早期预警评分2(NEWS2)预测肺炎病情进展的效能。方法选取2020年4月—2023年3月收治的105例肺炎,根据病情进展情况分为未进展组、进展组,比较2组Th17/Treg、Th1/Th2、NEWS2评分,采用多因素Logistic回归分析建立多指标联合预测肺炎病情进展的模型,使用Stata 10.0软件确定最佳截断值及该位置的预测准确度,绘制受试者工作特征(ROC)曲线,用曲线下面积(AUC)评价各协变量及联合预测因子预测肺炎病情进展的效能。结果进展组Th17/Treg、NEWS2评分高于未进展组,Th1/Th2低于未进展组(P<0.01);Th17/Treg、NEWS2评分升高是肺炎病情进展的独立危险因素,Th1/Th2升高是肺炎病情进展的独立保护因素(P<0.01);将原始协变量拟合,生成新联合预测因子New-pre,其最佳截断值为0.102,此时预测准确率为97.00%;绘制ROC曲线显示,New-pre预测肺炎病情进展的AUC(0.916)高于Th17/Treg(0.704)、Th1/Th2(0.747)、NEWS2评分(0.819)(P<0.05)。结论肺炎病情进展患者Th17/Treg、NEWS2评分升高,Th1/Th2降低,三者联合可作为预测个体病情进展定量方案,可为临床治疗、病情进展评估提供参考依据。

Objective To study the efficacy of Th17/Treg and Th1/Th2 combined with Nations Early Warning Score 2(NEWS2)in predicting the progression of pneumonia.Methods A total of 105 patients with pneumonia admitted from April 2020 to March 2023 were selected and divided into non-progression group and progression group according to the progression of the disease.The Th17/Treg,Th1/Th2 and NEWS2 scores of the two groups were compared,and a multi-indicator combined prediction model for the progression of pneumonia was established by Logistic regression.Stata 10.0 software was used to determine the optimal threshold and the prediction accuracy of this location,and the receiver operating characteristic(ROC)curve was plotted.The area under the curve(AUC)was used to evaluate the effectiveness of covariates and joint predictors to predict the progression of pneumonia.Results Th17/Treg and NEWS2 scores in the progression group were higher than those in the non-progression group,while Th1/Th2 was lower than that in the non-progression group(P<0.01).An increase inTh17/Treg and NEWS2 scores was an independent risk factor for the progression of pneumonia,and an increase in Th1/Th2 was an independent protective factor for the progression of pneumonia(P<0.01).The original covariate was fitted to generate a new joint predictor New-pre,with optimal critical value of 0.102,and the prediction accuracy of 97.00%.ROC curve showed that the AUC(0.916)of New-pre in predicting the progression of pneumonia was higher than Th17/Treg(0.704),Th1/Th2(0.747)and NEWS2 score(0.819)(P<0.05).Conclusion Th17/Treg and NEWS2 scores increased and Th1/Th2 scores decreased in patients with pneumonia progression.The combination of the three can be used as a quantitative scheme to predict individual disease progression,and can provide a reference for clinical treatment and assessment of disease progression.