摘要
目的分析血清纤维凝胶蛋白3(Ficolin-3)、C5b-9对老年慢性心力衰竭(CHF)合并肺部感染患者预后不良的预测价值。方法选取2022年10月至2024年10月于唐山中心医院就诊的老年CHF合并肺部感染患者220例,根据随访预后情况分为预后不良组59例和预后良好组161例。比较两组一般资料、Ficolin-3、C5b-9差异,采用多因素Logistic逐步回归分析老年CHF合并肺部感染患者预后不良的影响因素,采用受试者工作特征(ROC)曲线下面积(AUC)评估Ficolin-3、C5b-9对老年CHF合并肺部感染患者预后不良的预测价值。结果预后不良组血清Ficolin-3水平显著低于预后良好组,C5b-9水平显著高于预后良好组[(13.47±2.30)μg/mL vs(18.72±3.51)μg/mL、(297.25±19.46)ng/mL vs(232.84±17.58)ng/mL,P<0.05]。多因素Logistic逐步回归分析显示,NYHA心功能分级Ⅲ~Ⅳ级、侵入性操作、降钙素原升高、C5b-9≥265.05 ng/mL是老年CHF合并肺部感染患者预后不良的危险因素(OR=2.795,95%CI:1.405~5.562,P=0.003;OR=2.861,95%CI:1.528~5.356,P=0.001;OR=1.850,95%CI:1.209~2.830,P=0.005;OR=2.793,95%CI:1.443~5.406,P=0.002);Ficolin-3≥16.10μg/mL是老年CHF合并肺部感染患者预后不良的保护因素(OR=0.393,95%CI:0.225~0.686,P=0.001)。Ficolin-3联合C5b-9预测老年CHF合并肺部感染患者预后不良的AUC为0.907,显著高于Ficolin-3、C5b-9单独预测的0.784、0.856(Z=10.072、9.864,P<0.001)。结论Ficolin-3降低、C5b-9升高与老年CHF合并肺部感染患者预后不良密切相关,两者联合检测的预测价值显著优于单独预测,可作为评估预后的生物学标志物。
Objective To analyze the predictive value of serum Ficolin-3 and C5b-9 for poor prognosis in elderly patients with chronic heart failure(CHF)complicated with pulmonary infection.Methods A total of 220 elderly patients with CHF complicated with pulmonary infection who received treatment at Tangshan Central Hospital from October 2022 to October 2024 were selected.According to the prognosis during the follow-up period,the patients were divided into the poor prognosis group(59 cases)and the good prognosis group(161 cases).The differences in general data,Ficolin-3 and C5b-9 between the two groups were compared.The influencing factors of poor prognosis in elderly CHF patients with pulmonary infection were investigated by multivariate logistic stepwise regression analysis.The predictive value of Ficolin-3 and C5b-9 for poor prognosis in elderly CHF patients with pulmonary infection was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC).Results The serum Ficolin-3 level in the poor prognosis group was significantly lower than that in the good prognosis group,and the serum C5b-9 level was significantly higher than that in the good prognosis group[(13.47±2.30)μg/mL vs(18.72±3.51)μg/mL;(297.25±19.46)ng/mL vs(232.84±17.58)ng/mL,P<0.05].Multivariate Logistic stepwise regression analysis showed that NYHA cardiac function classⅢ-Ⅳ,invasive procedures,elevated procalcitonin,and C5b-9≥265.05 ng/mL were independent risk factors for poor prognosis in elderly patients(OR=2.795,95%CI:1.405-5.562,P=0.003;OR=2.861,95%CI:1.528-5.356,P=0.001;OR=1.850,95%CI:1.209-2.830,P=0.005;OR=2.793,95%CI:1.443-5.406,P=0.002);Ficolin-3≥16.10μg/mL was an independent protective factor(OR=0.393,95%CI:0.225-0.686,P=0.001).The AUC for predicting poor prognosis using the combination of Ficolin-3 and C5b-9 was 0.907,significantly higher than the AUC values of 0.784 and 0.856 for Ficolin-3 and C5b-9 alone,respectively(Z=10.072,9.864,P<0.001).Conclusion Decreased Ficolin-3 and elevated C5b-9 are closely related to poor prognosis in elderly patients with CHF complicated with pulmonary infection.The predictive value of combined detection is significantly better than that of single detection,and they can serve as biomarkers for prognosis assessment.
作者
黄琨
张红利
徐晶晶
史艳霞
张春来
HUANG Kun;ZHANG Hongli;XU Jingjing;SHI Yanxia;ZHANG Chunlai(Department of Cardiology,Tangshan Central Hospital,Tangshan,Hebei 063000,China)
出处
《转化医学杂志》
2025年第7期18-23,共6页
Translational Medicine Journal
基金
河北省医学科学研究课题项目(20221843)。
