老年特发性间质性肺炎病人血清S100A9及sCD163表达水平及临床意义

Expression levels and clinical significance of serum S100A9 and sCD163 in elderly patients with idiopathic interstitial pneumonia

目的研究老年特发性间质性肺炎(IIP)病人血清S100钙结合蛋白A9(S100A9)、分泌型CD163(sCD163)表达水平及其临床意义。方法选取自2019年5月至2022年5月于本院诊治的96例老年IIP病人,根据IIP病情分为急性加重期组(n=62)和稳定期组(n=34)。根据急性加重期组病人随访3个月生存情况,分为生存亚组(n=40)和死亡亚组(n=22)。以同期体检的60例健康人为对照组。采用ELISA法检测血清S100A9、sCD163水平。采用多因素Logistic回归分析急性加重期IIP病人死亡的影响因素,采用ROC曲线分析血清S100A9、sCD163对急性加重期IIP病人死亡的预测价值。结果急性加重期组血清S100A9、sCD163水平明显高于稳定期组和对照组,差异具有统计学意义(均P<0.01)。急性加重期老年IIP病人血清S100A9、sCD163水平均与红细胞沉降率、肺部高分辨率计算机断层扫描成像(HRCT)评分呈正相关(均P<0.05)。多因素Logistic回归分析显示,HRCT评分、S100A9、sCD163是急性加重期老年IIP病人死亡的独立影响因素。ROC曲线分析显示,HRCT评分、血清S100A9、sCD163联合检测预测急性加重期老年IIP病人死亡的AUC为0.907,大于上述单一指标(AUC=0.850,0.809,0.792),差异具有统计学意义(Z=5.183,4.349,5.127,均P<0.05)。结论老年IIP病人血清S100A9和sCD163联合检测对急性加重期老年IIP病人死亡具有较高的预测价值。

Objective To study the levels of serum S100 calcium binding protein A9(S100A9)and soluble CD163(sCD163)in the elderly patients with idiopathic interstitial pneumonia(IIP),and to explore their clinical significance.Methods A total of 96 elderly patients with IIP who were treated in our hospital from May 2019 to May 2022 were selected.According to the severity of IIP,the patients were divided into acute exacerbation group(n=62)and stable phase group(n=34).According to the 3-month follow-up of the patients in the acute exacerbation group,they were divided into survival subgroup(n=40)and death subgroup(n=22).Sixty healthy individuals who underwent physical examination during the same period were selected as the control group.Enzyme linked immunosorbent assay was used to detect the serum levels of S100A9 and sCD163.Multivariate Logistic regression analysis was used to investigate the influencing factors of death in the elderly patients with acute exacerbation phase of IIP.The predictive value of serum S100A9 and sCD163 for mortality in the patients with acute exacerbation of IIP was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of S100A9 and sCD163 in the acute exacerbation group were significantly higher than those in the stable phase group and the control group(all P<0.01).The levels of serum S100A9 and sCD163 in the elderly patients with acute exacerbation phase of IPP were positively correlated with erythrocyte sedimentation rate and high resolution computed tomography(HRCT)score(all P<0.05).Multivariate Logistic regression analysis showed that HRCT scores,the levels of S100A9 and sCD163 were the independent influencing factors for mortality in the elderly patients with acute exacerbation phase of IIP.ROC curve analysis showed that the area under the curve(AUC)of the combination of HRCT score,serum S100A9 and sCD163 in predicting mortality in the elderly patients with acute exacerbation phase of IIP was 0.907,which was higher than that of the single indicator(Z=5.183,4.349,5.127,all P<0.05).Conclusions The combination detection of S100A9 and sCD163 has high predictive value for mortality in the elderly patients with acute exacerbation phase of IIP.