摘要
目的研究血清淀粉样蛋白A/C反应蛋白(SAA/CRP)比值与老年阿尔茨海默病(AD)住院患者肺部感染的关系。方法选取2023年4月至2025年3月雅安市第四人民医院收治的120例老年AD住院患者作为研究对象,其中住院期间合并肺部感染者38例(感染组),未合并肺部感染者82例(未感染组)。检测两组患者血清SAA、CRP水平,并计算SAA/CRP比值。构建受试者工作特征(ROC)曲线及曲线下面积(AUC)分析各指标对老年AD住院患者肺部感染的评估价值,并采用二分类Logistic逐步回归分析老年AD住院患者肺部感染的影响因素。结果感染组患者SAA、CRP及SAA/CRP比值高于未感染组(P<0.05)。SAA、CRP及SAA/CRP比值评估老年AD患者肺部感染的AUC(95%CI)分别为0.828(0.783~0.878)、0.773(0.728~0.823)、0.906(0.861~0.956),SAA/CRP比值评估的AUC高于SAA、CRP单独评估的AUC(Z=9.301,P<0.001;Z=12.257,P<0.001)。感染组患者年龄≥75岁、合并糖尿病、吸烟史、长期制动、进食困难、改良牙菌斑指数(mPLI)≥2分的比例高于未感染组(P<0.05)。二分类Logistic逐步回归分析显示:长期制动(OR=2.094,95%CI:1.088~4.029)、糖尿病(OR=2.192,95%CI:1.153~4.170)、mPLI(OR=2.270,95%CI:1.239~4.161)、SAA/CRP比值(OR=3.714,95%CI:2.055~6.712)是老年AD住院患者肺部感染的影响因素(P<0.05)。结论血清SAA/CRP比值升高与老年AD住院患者肺部感染风险密切关联,有望为临床识别高危人群和优化干预策略提供重要依据。
Objective To explore the relationship between serum amyloid A/C-reactive protein(SAA/CRP)ratio and pulmonary infection in elderly hospitalized patients with Alzheimer's disease(AD).Methods A total of 120 elderly AD inpatients from the Fourth People's Hospital of Ya'an City from April 2023 to March 2025 were selected as the research subjects,including 38 patients with pulmonary infections during hospitalization(infection group)and 82 patients without pulmonary infections(non-infection group).Serum SAA and CRP levels were measured and the SAA/CRP ratio was calculated for both groups.Receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to analyze the assessment value of each index for pulmonary infection in elderly AD inpatients.Binary logistic stepwise regression analysis was employed to identify influencing factors for pulmonary infection in elderly AD inpatients.Results SAA,CRP levels,and the SAA/CRP ratio were higher in the infection group than in the non-infection group(P<0.05).The AUC(95%CI)for SAA,CRP,and the SAA/CRP ratio in evaluating pulmonary infection in elderly AD patients were 0.828(0.783-0.878),0.773(0.728-0.823),and 0.906(0.861-0.956),respectively.The AUC of the SAA/CRP ratio assessment was higher than that of SAA and CRP evaluation alone(Z=9.301,P<0.001;Z=12.257,P<0.001).The proportion of patients with age≥75 years,diabetes,smoking history,long-term immobilization,eating difficulties,and modified plaque index(mPLI)≥2 was higher in the infection group than in the non-infection group(P<0.05).Binary logistic stepwise regression analysis showed that long-term immobilization(OR=2.094,95%CI:1.088-4.029),diabetes(OR=2.192,95%CI:1.153-4.170),mPLI≥2(OR=2.270,95%CI:1.239-4.161),and SAA/CRP ratio(OR=3.714,95%CI:2.055-6.712)were independent influencing factors of pulmonary infection in elderly AD inpatients(P<0.05).Conclusion The elevated serum SAA/CRP ratio is closely associated with the risk of pul monary infection in elderly hospitalized AD patients,and is expected to provide important evidence for clinical identification of high-risk populations and optimization of intervention strategies.
作者
杨小燕
吴国林
涂尊魁
张莹
向敏
吴雅锋
YANG Xiaoyan;WU Guolin;TU Zunkui;ZHANG Ying;XIANG Min;WU Yafeng(Department of Laboratory Medicine,Ya'an Fourth People's Hospital,Ya'an,Sichuan 625000,China;Department of Geriatrics,Ya'an Fourth People's Hospital,Ya'an,Sichuan 625000,China)
出处
《转化医学杂志》
2025年第7期13-17,共5页
Translational Medicine Journal
基金
四川省科技计划项目(2021YJ0166)
四川省基层卫生事业发展研究中心科研项目(SWFZ24-Y-81)。
