外周血CXCL10、CXCL12在老年重症肺炎合并呼吸衰竭患者中的表达及其临床意义OA
Expression and clinical significance of CXCL10 and CXCL12 in peripheral blood of elderly patients with severe pneumonia complicated by respiratory failure
目的 探讨外周血CXC趋化因子配体10(CXCL10)、CXC趋化因子配体12(CXCL12)在老年重症肺炎合并呼吸衰竭患者中的表达及其临床意义.方法 选取上海德济医院2022年7月—2024年12月收治的老年重症肺炎合并呼吸衰竭患者168例,比较不同病情程度患者外周血CXCL10、CXCL12水平,采用Spearman相关性分析二者与病情程度的相关性.所有患者均给予规范治疗并随访30 d,根据预后情况分为预后良好组与预后不良组,比较两组临床资料、外周血CXCL10、CXCL12水平,平滑曲线拟合分析外周血CXCL10、CXCL12与患者预后的关系,同时分析二者对预后的影响、交互作用以及预后预测效能.结果 外周血CXCL10、CXCL12在低危、中危和高危患者中呈依次升高表达(P<0.05).外周血CXCL10、CXCL12与患者病情程度呈正相关(r=0.715、0.781,P均<0.001).预后不良组外周血CXCL10、CXCL12水平高于预后良好组(P<0.05);平滑曲线拟合显示,外周血CXCL10、CXCL12与患者预后呈线性关系,随着二者水平升高患者预后不良风险呈逐渐增加趋势(P<0.05).多因素Logistic回归分析显示,外周血CXCL10、CXCL12是患者预后的独立影响因素(P<0.05),且CXCL10与CXCL12在患者预后评估中呈正向交互作用(γ=2.547,P<0.001).受试者工作特征曲线分析显示,外周血CXCL10、CXCL12联合预测患者预后的曲线下面积为0.865,敏感度为85.37%,特异度为74.80%,价值显著优于二者单独预测(P<0.05).结论 外周血CXCL10、CXCL12与老年重症肺炎合并呼吸衰竭患者病情程度密切相关,也是预后的独立影响因素,可作为预后的独立预测因子,且联合预测价值更高.
Objective To investigate the expression and clinical significance of C-X-C motif chemokine ligand 10(CXCL10)and C-X-C motif chemokine ligand 12(CXCL12)in elderly patients with severe pneumonia complicated by respiratory failure.Methods A total of 168 elderly patients with severe pneumonia complicated by respiratory failure admitted to Shanghai Deji Hospital from July 2022 to December 2024 were selected.The levels of CXCL10 and CXCL12 in peripheral blood were compared among patients with different levels of severity.Spearman correlation analysis was used to investigate the correlation between the levels of CXCL10 and CXCL12 in peripheral blood and the severity of the condition.All patients received standardized treatment and were followed up for 30 d.Based on their prognosis,they were divided into good prognosis group and poor prognosis group.The clinical data and levels of CXCL10 and CXCL12 in peripheral blood were compared between the two groups.Smoothing curve fitting was used to analyze the relationship of peripheral blood CXCL10 and CXCL12 with patient prognosis,and their prognostic impacts,interaction effects and prognostic predictive efficacy were analyzed.Results The expression of CXCL10 and CXCL12 in peripheral blood was sequentially increased in low-risk,medium-risk,and high-risk patients(P<0.05).Peripheral blood CXCL10 and CXCL12 were positively correlated with disease severity(r=0.715,0.781,both P<0.001).The levels of peripheral blood CXCL10 and CXCL12 in the poor prognosis group were higher than those in the good prognosis group(P<0.05).Smooth curve fitting showed that CXCL10 and CXCL12 were linearly correlated with patient prognosis,and the risk of poor prognosis increased gradually with the elevation of their levels(P<0.05).Multivariate logistic regression analysis revealed that peripheral blood CXCL10 and CXCL12 were independent influencing factors for patient prognosis(P<0.05),and there was a positive interaction between CXCL10 and CXCL12 in prognostic evaluation(γ=2.547,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the area under the ROC curve(AUC)of combined detection of peripheral blood CXCL10 and CXCL12 for predicting prognosis was 0.865,with a sensitivity of 85.37%and a specificity of 74.80%,which was significantly superior to the predictive value of single index alone(P<0.05).Conclusion Peripheral blood CXCL10 and CXCL12 are closely related to the severity of disease in elderly patients with severe pneumonia complicated by respiratory failure,and are independent factors affecting prognosis.They can serve as independent predictors of prognosis,and their combined predictive value is even higher.
邱淑佳;郭霞;陆月明;程东帅;毛贝
上海德济医院呼吸内科,上海 200331上海德济医院呼吸内科,上海 200331上海德济医院呼吸内科,上海 200331上海德济医院呼吸内科,上海 200331上海市肺科医院呼吸与危重症医学科,上海 200082
重症肺炎呼吸衰竭老年CXC趋化因子配体10CXC趋化因子配体12预后影响因素
severe pneumoniarespiratory failureelderlyC-X-C motif chemokine ligand 10C-X-C motif chemokine ligand 12prognosisinfluencing factor
《临床误诊误治》 2026 (11)
25-31,7
国家自然科学基金资助项目(82200053)
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