血清S100A2联合S100A11预测AECOPD患者发生呼吸机相关性肺炎的价值及与预后的关系

Value of Serum S100A2 Combined with S100A11 in Predicting Ventilator Associated Pneumonia in AECOPD Patients and its Relationship with Prognosis

目的:探讨血清S100钙结合蛋白A2(S100A2)联合S100A11预测慢性阻塞性肺疾病急性加重(AECOPD)患者发生呼吸机相关性肺炎(VAP)的价值及与预后的关系。方法:选取2021年1月~2022年1月南京中医药大学泰州附属医院收治的175例AECOPD患者,根据VAP发生情况将患者分为非VAP组和VAP组,根据28d生存状态将AECOPD并发VAP患者分为死亡组和存活组。采用酶联免疫吸附法检测血清S100A2、S100A11水平。通过多因素Logistic回归分析AECOPD患者发生VAP的影响因素,受试者工作特征(ROC)曲线分析血清S100A2联合S100A11预测AECOPD患者发生VAP的价值和预测AECOPD并发VAP患者死亡的价值。结果:175例AECOPD患者VAP发生率为41.14%。VAP组血清S100A2、S100A11水平高于非VAP组(P<0.05)。多因素Logistic回归分析显示,COPD病程延长、临床肺部感染评分(CPIS)增加、机械通气时间>4 d、入院后再次插管和S100A2、S100A11升高为AECOPD患者发生VAP的独立危险因素(P<0.05)。72例AECOPD并发VAP患者28 d死亡率为19.44%。与存活组比较,死亡组血清S100A2、S100A11水平升高(P<0.05)。血清S100A2联合S100A11预测AECOPD患者发生VAP的曲线下面积(AUC)为0.858,血清S100A2联合S100A11预测AECOPD并发VAP患者死亡的AUC为0.798。血清S100A2联合S100A11预测AECOPD患者发生VAP的价值和预测AECOPD并发VAP患者死亡的价值均大于各指标单独预测。结论:血清S100A2升高、S100A11升高与AECOPD患者发生VAP和预后不良有关,血清S100A2联合S100A11预测AECOPD患者发生VAP和预后不良的价值较高。

Objective:To investigate the value of serum S100 calcium binding protein A2(S100A2)combined with S100A11 in predicting ventilator associated pneumonia(VAP)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and its relationship with prognosis.Methods:175 AECOPD patients admitted to Taizhou Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2021 to January 2022 were selected,patients were divided into non VAP group and VAP group according to the occurrence of VAP,and AECOPD patients complicated with VAP were divided into death group and survival group according to the 28 days survival situation.Serum S100A2 and S100A11 levels were detected by enzyme linked immunosorbent assay.The influencing factors of VAP in AECOPD patients were analyzed by multivariate Logistic regression analysis,the value of serum S100A2 combined with S100A11 in predicting VAP in AECOPD patients and predicting the value of death in AECOPD patients with VAP were analyzed by receiver operating characteristic(ROC)curve.Results:The incidence of VAP in 175 AECOPD patients was 41.14%.The levels of serum S100A2 and S100A11 in VAP group were higher than those in non VAP group(P<0.05).Multivariate Logistic regression analysis showed that,prolonged COPD course,increased clinical pulmonary infection score(CPIS),mechanical ventilation time>4 d,re-intubation after admission and increased S100A2 and S100A11 were independent risk factors for VAP in AECOPD patients(P<0.05).The 28 days mortality rate of 72 AECOPD patients complicated with VAP was 19.44%.Compared with survival group,the serum levels of S100A2 and S100A11 in death group were increased(P<0.05).The area under the curve(AUC)of serum S100A2 combined with S100A11 for predicting VAP in AECOPD patients was 0.858.The AUC of serum S100A2 combined with S100A11 in predicting the death of patients with AECOPD complicated with VAP was 0.798.The value of serum S100A2 combined with S100A11 in predicting the occurrence of VAP in AECOPD patients and predicting the death of AECOPD patients complicated with VAP was greater than that of each index alone.Conclusion:Elevated serum S100A2 and S100A11 levels are associated with VAP and poor prognosis in AECOPD patients,and the value of serum S100A2 combine with S100A11 in predicting VAP and poor prognosis in AECOPD patients is high.