摘要
目的分析肝素结合蛋白(heparin-binding protein,HBP)及降钙素原(procalcitonin,PCT)对肺炎严重程度的预测意义。方法选取2023年1月至2023年12月习水县人民医院呼吸与危重症医学科收治的肺炎患者87例,非重症肺炎43例分为对照组,重症肺炎44例为观察组。检测两组HBP、PCT、白细胞介素-6(interleukin-6,IL-6)、D二聚体(D-Dimer,DD)、白细胞(white blood cell,WBC)、中性粒细胞百分比(neutrophil percentage,N%)水平;利用Mann-Whitney U检验分析组间差异,组间比较采用χ^(2)检验或Fisher确切概率检验,绘制ROC曲线分析HBP、PCT、IL-6、DD、WBC、N%对肺炎严重程度的诊断价值。结果两组肺炎患者性别、年龄、体温、病史等差异无统计学意义(P>0.05);观察组呼吸频率(29.11±8.44)次/min、脉搏(107.09±20.98)次/min较对照组呼吸频率(23.09±3.22)次/min、脉搏(93.77±14.00)次/min快(P<0.05)。观察组HBP 166.99(135.61,198.36)ng/ml、PCT 8.23(1.44,15.02)ng/ml、IL-6596.09(112.52,1079.66)pg/ml、DD 1588.57(774.15,2402.99)ng/ml、WBC 14.57(11.90,17.25)×10^(9)/L高于对照组HBP 79.26(66.47,92.051)ng/ml、PCT8.23(1.44,15.02)ng/ml、IL-656.16(-7.06,119.38)pg/ml、DD410.73(267.91,553.55)ng/ml、WBC 8.88(7.44,10.31)×10^(9)/L(P<0.05);受试者工作特征(receiver operating characteristic,ROC)曲线分析显示,HBP截断值为138.23 ng/ml时,预测重症肺炎AUC为0.77,敏感性为0.591,特异性为0.9683(P<0.05);PCT截断值为0.39 ng/ml时,预测重症肺炎AUC为0.76,敏感性为0.684,特异性为0.80(P<0.05);IL-6截断值为54.3 pg/ml时,预测重症肺炎AUC为0.674,敏感性为0.522,特异性为0.896(P<0.05);DD截断值为343.80 ng/ml时,预测重症肺炎AUC为0.730,敏感性为0.773,特异性为0.664(P<0.05)。结论重症肺炎患者血液HBP和PCT水平升高,具有预测价值,两者联合检测有助于识别重症肺炎,具有临床意义。
Objective To analyze the predictive significance of heparin-binding protein(HBP)and procalcitonin(PCT)on the severity of pneumonia.Methods A total of 87 pneumonia patients admitted to the Department of Respiratory and Critical Care Medicine at Xishui County People′s Hospital from January 2023 to December 2023 were selected.Among them,43 non-severe pneumonia cases were classified as the control group,and 44 severe pneumonia cases as the observation group.Levels of HBP,PCT,interleukin-6(IL-6),D-dimer(DD),white blood cell count(WBC),and neutrophil percentage(N%)were measured in both groups.The Mann-Whitney U test was used to analyze intergroup differences,while theχ^(2) test or Fisher′s exact test was employed for categorical comparisons.Receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic value of HBP,PCT,IL-6,DD,WBC,and N%in predicting pneumonia severity.Results No statistically significant differences were observed between the two groups in terms of gender,age,body temperature,or medical history(P>0.05).The observation group exhibited higher respiratory rates(29.11±8.44)breaths/min and pulse rates(107.09±20.98)breaths/min compared to the control group(23.09±3.22)breaths/min and(93.77±14.00)breaths/min,respectively(P<0.05).The observation group also showed elevated levels of HBP 166.99(135.61,198.36)ng/ml,PCT 8.23(1.44,15.02)ng/ml,IL-6596.09(112.52,1079.66)pg/ml,DD 1588.57(774.15,2402.99)ng/ml,and WBC 14.57(11.90,17.25)×10^(9)/L compared to the control group HBP 79.26(66.47,92.05)ng/ml;PCT:8.23(1.44,15.02)ng/ml;IL-6:56.16(-7.06,119.38)pg/ml;DD:410.73(267.91,553.55)ng/ml;WBC:8.88(7.44,10.31)×10^(9)/L(P<0.05).ROC curve analysis revealed that HBP cutoff:138.23 ng/ml predicted severe pneumonia with an AUC of 0.77,sensitivity of 0.591,and specificity of 0.968(P<0.05).PCT cutoff:0.39 ng/ml showed an AUC of 0.76,sensitivity of 0.684,and specificity of 0.80(P<0.05).IL-6 cutoff:54.3 pg/ml demonstrated an AUC of 0.674,sensitivity of 0.522,and specificity of 0.896(P<0.05),while DD cutoff:343.80 ng/ml yielded an AUC of 0.730,sensitivity of 0.773,and specificity of 0.664(P<0.05).Conclusion Elevated blood levels of HBP and PCT in severe pneumonia patients demonstrate predictive value.Combined detection of these biomarkers aids in identifying severe pneumonia and holds clinical significance.
作者
赖乾德
吕小容
吕相琴
刘艺
刘秀
杨明花
李琦
Lai Qiande;Lyu Xiaorong;Lyu Xiangqin;Liu Yi;Liu Xiu;Yang Minghua;Li Qi(Department of Respiratory and Critical Care Medicine,Xishui County People′s Hospital,Guizhou Province,Xishui,564600 China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)
出处
《中华肺部疾病杂志(电子版)》
2025年第4期570-574,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
重症肺炎
肝素结合蛋白
降钙素原
Severe pneumonia
Heparin-binding protein
Procalcitonin
