实用老年医学

实用老年医学 ›› 2023, Vol. 37 ›› Issue (2): 142-146.doi: 10.3969/j.issn.1003-9198.2023.02.009

• 临床研究 • 上一篇    下一篇

血清sCD163/sTWEAK比值与老年社区获得性肺炎住院病人不良心血管事件的相关性分析

刘航序, 孙成龙, 冯在榜, 靳钰   

  1. 200082 上海市,海军军医大学第一附属医院疾病预防控制科(刘航序,孙成龙,冯在榜);呼吸与危重症学科(靳钰)
  • 收稿日期:2022-03-14 出版日期:2023-02-20 发布日期:2023-02-27
  • 通讯作者: 靳钰,Email:jwb2008jy@163.com

Correlation between serum sCD163/sTWEAK ratio and adverse cardiovascular events in elderly hospitalized patients with community acquired pneumonia

LIU Hang-xu, SUN Cheng-long, FENG Zai-bang, JIN Yu   

  1. Department of Disease Prevention and Control(LIU Hang-xu, SUN Cheng-long, FENG Zai-bang); Department of Respiratory and Critical Care Medicine(JIN Yu), the First Hospital of Naval Military Medical University, Shanghai 200082, China
  • Received:2022-03-14 Online:2023-02-20 Published:2023-02-27
  • Contact: JIN Yu, Email: jwb2008jy@163.com

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摘要： 目的 分析可溶性血红蛋白清道夫受体163蛋白(sCD163)/可溶性肿瘤坏死因子样凋亡弱诱导因子(sTWEAK)比值与社区获得性肺炎(CAP)住院病人发生不良心血管事件(CVE)的相关性。方法 选取本院收治的CAP病人154例为研究对象,根据是否合并CVE分为CVE组及无CVE组。统计所有病人30 d生存情况,并进一步分为死亡组及生存组。采用Logistic多因素回归分析影响CVE发生的相关因素,采用COX回归模型分析CAP病人入院30 d内死亡的影响因素。结果 CVE组年龄、白细胞计数、血小板计数、sCD163、sTWEAK及sCD163/sTWEAK以及高血压、冠心病、慢性心力衰竭、慢性肾脏病、意识改变、PSI评分≥Ⅳ级、酸中毒、低白蛋白血症病人比例均高于无CVE组(P＜0.05)。多因素Logistic回归分析显示,年龄、慢性心力衰竭、PSI评分及sCD163/sTWEAK是影响CAP住院病人发生CVE的独立危险因素(P＜0.05)。死亡组病人血清sCD163/sTWEAK明显高于生存组(P＜0.05),且sCD163/sTWEAK≥0.35是CAP病人入院30 d内死亡的独立危险因素。结论 随着血清sCD163/sTWEAK升高,CAP病人发生CVE的风险及30 d内病死率增加。

关键词: 可溶性血红蛋白清道夫受体163蛋白, 可溶性肿瘤坏死因子样凋亡弱诱导因子, 社区获得性肺炎, 心血管事件

Abstract: Objective To analyze the association of soluble haemoglobin scavenger receptor (sCD163)/soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK) ratio with adverse cardiovascular events (CVE) in the elderly hospitalized patients with community acquired pneumonia (CAP). Methods A total of 154 CAP patients admitted to our hospital were selected and divided into the CVE group and the non-CVE group. The 30-day survival of all patients was recorded,and the patients were further divided into the death group and the survival group. Multivariate Logistic regression was used to analyze the related factors affecting the occurrence of CVE. COX regression model was used to analyze the influencing factors of death within 30 days of admission in the elderly patients with CAP. Results The proportion of patients with hypertension, coronary heart disease, chronic heart failure, chronic kidney disease, altered consciousness age, pneumonia severity index(PSI)score≥grade Ⅳ, acidosis, hypoalbuminemia and the levels of white blood cell count, platelet count, sCD163, sTWEAK and sCD163/sTWEAK ratio in the CVE group were significantly higher than those in the non-CVE group (P<0.05).Multivariate Logistic regression analysis showed that age, chronic heart failure, PSI score and sCD163/sTWEAK ratio were the independent risk factors for CVE (P＜0.05).The serum sCD163/sTWEAK ratio of CAP patients in the death group was higher than that in the survival group (P<0.05),and sCD163/sTWEAK ratio≥0.35 was an independent risk factor for death within 30 days of admission in the elderly patients with CAP. Conclusions With the increase of serum sCD163/sTWEAK ratio, the risk of CVE and 30-day mortality in CAP patients increase.

Key words: soluble haemoglobin scavenger receptor, soluble tumor necrosis factor-like weak inducer of apoptosis, community acquired pneumonia, cardiovascular event

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