血清14-3-3β蛋白CD5L与支气管哮喘合并肺部感染成人患者预后不良风险的相关性分析OA

Objective:To investigate the correlation between serum 14-3-3β protein,CD5 antigen-like protein(CD5L),and the risk of poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection.Methods:A total of 155 adult patients with bronchial asthma complicated by pulmonary infection in 909th Hospital from January 2022 to January 2024 were selected.All patients received standard-ized treatment for bronchial asthma and individualized anti-infective therapy.They were followed up for one year and categorized into a good prognosis group and a poor prognosis group based on their prognosis.The clinical data,serum 14-3-3β protein,and CD5L levels were compared between the two groups.Logistic re-gression analysis was used to identify the influencing factors of poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection.Smooth curve fitting analysis was employed to explore the relation-ship between serum 14-3-3β protein,CD5L,and the risk of poor prognosis.Receiver Operating Characteris-tic(ROC)curves and Area Under the Curve(AUC)were used to assess the predictive value of serum 14-3-3β protein and CD5L for poor prognosis risk.The interaction index(γ)was used to analyze the interactive effect of serum 14-3-3β protein and CD5L on poor prognosis risk.Results:At a 1-year follow-up,4 cases were lost to follow-up,104 cases had a good prognosis,and 47 cases had a poor prognosis.The serum level of 14-3-3β protein was higher in the poor prognosis group than in the good prognosis group,while the level of CD5L was lower(P<0.05).Logistic regression analysis indicated that serum 14-3-3β protein and CD5L levels were risk factors for poor prognosis in adult patients with bronchial asthma complicated by pulmonary in-fection(P<0.05).Smooth curve fitting analysis showed that after adjusting for other factors,serum 14-3-3β protein level exhibited a monotonically positive correlation with the risk of poor prognosis in adult patients with bronchial asthma complicated with pulmonary infection(P<0.05),and serum CD5 L level showed a mono-tonically negative correlation with the risk of poor prognosis in adult patients with bronchial asthma complicated with pulmonary infection(P<0.05).The AUC values for predicting poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection using serum 14-3-3β protein and CD5L levels were 0.755 and 0.779,respectively.The optimal cutoff values were 57.84 ng/mL and 177.73 pg/mL,with sensitiv-ities of 82.98%and 68.09%,and specificities of 63.46%and 80.77%,respectively.The combined predic-tion of poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection had an AUC of 0.884,a sensitivity of 76.60%,and a specificity of 87.50%,showing significantly higher predictive value than either individual predictor alone(Z=2.542,2.129,P=0.011,0.033).High expression of serum 14-3-3β protein and low expression of CD5L showed a positive interaction in predicting poor prognosis in adult patients with bronchial asthma complicated by pulmonary infection(γ=2.344,P<0.001).Conclusion:Ser-um 14-3-3β protein and CD5L are independent factors influencing the poor prognosis risk in adult patients with bronchial asthma complicated by pulmonary infection.Furthermore,high expression of serum 14-3-3β protein and low expression of CD5L exhibit a positive interaction,indicating a high combined predictive value.