老年社区获得性肺炎患者血清NLRP3、Gal-3水平与病情严重程度的关系OA
Relationship of serum NLRP3 and Gal-3 levels with disease severity in elderly patients with community-acquired pneumonia
目的 探讨老年社区获得性肺炎(CAP)患者血清核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、半乳糖凝集素-3(Gal-3)水平与病情严重程度的关系.方法 选择2023年6月至2025年6月该院收治的79例老年CAP患者作为观察组,根据入院时肺炎严重程度指数(PSI),将PSI为Ⅰ～Ⅲ级的患者纳入轻症组(35例),PSI为Ⅳ～Ⅴ级的患者纳入重症组(44例).另选取同期在该院进行体检的50例健康老年人作为对照组.检测所有研究对象全血超敏C反应蛋白(hs-CRP)及血清降钙素原(PCT)、NLRP3、Gal-3水平.采用Spearman相关或点二列相关分析各指标之间的相关性.采用多因素Logistic回归分析老年CAP患者发生重症的影响因素.采用受试者工作特征(ROC)曲线分析血清NLRP3、Gal-3单独及联合对老年CAP病情严重程度的评估价值.结果 观察组全血hs-CRP及血清 NLRP3、Gal-3、PCT水平明显高于对照组,差异均有统计学意义(P<0.05).重症组合并慢性阻塞性肺疾病比例、全血hs-CRP及血清PCT、NLRP3、Gal-3水平明显高于轻症组,差异均有统计学意义(P<0.05).老年CAP患者血清 NLRP3水平与全血hs-CRP及血清 Gal-3、PCT水平呈正相关(P<0.05);血清Gal-3水平与全血hs-CRP、血清PCT水平呈正相关(P<0.05),血清 NL-RP3、Gal-3水平与病情严重程度呈正相关(P<0.05).多因素Logistic回归分析结果显示,血清NLRP3、Gal-3水平升高是老年CAP患者发生重症的独立危险因素(P<0.05).ROC曲线分析结果显示,NLRP3、Gal-3单独及联合评估老年CAP患者为重症的曲线下面积分别为0.796、0.753、0.810.结论 老年 CAP患者血清NLRP3、Gal-3水平与病情严重程度有关,二者联合检测对老年CAP为重症的评估价值更高.
Objective To investigate the relationship of serum levels of nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and galectin-3(Gal-3)with disease severity in elderly patients with community-acquired pneumonia(CAP).Methods A total of 79 elderly patients with CAP admitted to the hospital from June 2023 to June 2025 were selected as the observation group.According to the pneumonia se-verity index(PSI)at admission,patients with PSI grades Ⅰ-Ⅲ were assigned to the mild group(35 cases),and those with PSI grades Ⅳ-Ⅴ were assigned to the severe group(44 cases).Additionally,50 healthy elder-ly individuals who underwent physical examination at the hospital during the same period were selected as the control group.Levels of whole blood high-sensitivity C-reactive protein(hs-CRP)and serum procalcitonin(PCT),NLRP3 and Gal-3 were measured in all study subjects.Spearman or point-biserial correlation analysis was conducted to assess the correlations among the indicators.Multivariate Logistic regression analysis was performed to identify the factors influencing the occurrence of severe illness in elderly patients with CAP.Re-ceiver operating characteristic(ROC)curve was plotted to evaluate the value of serum NLRP3 and Gal-3 a-lone and in combination in assessing the severity of CAP in elderly patients.Results The levels of whole blood hs-CRP and serum PCT,NLRP3 and Gal-3 in the observation group were higher than those in the con-trol group,with statistically significant differences(P<0.05).The proportion of patients with comorbid chronic obstructive pulmonary disease,levels of whole blood hs-CRP and serum PCT,NLRP3 and Gal-3 in the severe group were higher than those in the mild group,with statistically significant differences(P<0.05).In elderly patients with CAP,the serum NLRP3 level was positively correlated with whole blood hs-CRP,serum Gal-3 and serum PCT levels(P<0.05);the serum Gal-3 level was positively correlated with whole blood hs-CRP and serum PCT levels(P<0.05);and serum NLRP3 and Gal-3 levels were positively correlated with disease severity(P<0.05).Elevated serum NLRP3 and Gal-3 levels were identified as independent risk fac-tors for the occurrence of severe illness in elderly patients with CAP(P<0.05).The areas under the curves(AUCs)of NLRP3 alone,Gal-3 alone and their combination in assessing severe illness in elderly patients with CAP were 0.796,0.753,and 0.810 respectively.Conclusion The serum levels of NLRP3 and Gal-3 in elderly patients with CAP are associated with disease severity.Combined detection of both indicators demonstrates higher value in assessing severe CAP in elderly patients.
李慧;阳韬;张美;李搀;韩仰光
江苏省镇江市第一人民医院 感染性疾病科,江苏 镇江 212002江苏省镇江市第一人民医院 呼吸内科,江苏 镇江 212002江苏省镇江市第一人民医院 感染性疾病科,江苏 镇江 212002江苏省镇江市第一人民医院 感染性疾病科,江苏 镇江 212002江苏省镇江市第一人民医院 感染性疾病科,江苏 镇江 212002
医药卫生
社区获得性肺炎核苷酸结合寡聚化结构域样受体蛋白3半乳糖凝集素-3病情严重程度老年
community-acquired pneumonianucleotide-binding oligomerization domain-like receptor protein 3galectin-3disease severityelderly
《检验医学与临床》 2026 (12)
1671-1676,6
江苏省镇江市重点研发计划-社会发展项目(SH2020047).
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