老年社区获得性肺炎患者血清IL-12P70 4-HNE S100A12水平与病情严重程度及预后的相关性分析

doi:10.3969/j.issn.1006-6233.2025.05.08

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摘要 目的: 探讨老年社区获得性肺炎(CAP)患者血清白细胞介素-12P70(IL-12P70)、4-羟基壬烯醛(4-HNE)、钙结合蛋白(S100A12)水平与病情严重程度及预后的相关性。方法: 选取河北省胸科医院2022年4月至2024年6月收治的老年CAP患者158例作为研究组,另选取健康体检者158名作为对照组,对比研究组不同病情严重程度患者和对照组血清IL-12P70、4-HNE、S100A12水平、肺部感染评分(CPIS)、急性生理与慢性健康评价系统Ⅱ(APACHEⅡ)评分、肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)],分析血清IL-12P70、4-HNE、S100A12与病情严重程度评分的相关性。研究组均随访28d,根据预后分为预后良好亚组与预后不良亚组,对比两亚组临床资料、血清IL-12P70、4-HNE、S100A12水平,分析血清IL-12P70、4-HNE、S100A12与预后的相关性及预测效能。结果: 研究组血清IL-12P70、4-HNE、S100A12水平高于对照组(P<0.05);重症患者CPIS、APACHEⅡ评分、血清IL-12P70、4-HNE、S100A12水平高于非重症患者,FEV1、FVC低于非重症患者(P<0.05);Pearson相关性分析,血清IL-12P70、4-HNE、S100A12与CPIS、APACHEⅡ评分呈正相关,与FEV1、FVC呈负相关(P<0.05);随访28d,研究组预后不良33例,预后良好125例,分别纳入预后不良亚组与预后良好亚组。预后不良亚组年龄、重症比例、糖尿病比例、CPIS、APACHEⅡ评分、血清IL-12P70、4-HNE、S100A12水平高于预后良好亚组,FEV1、FVC低于预后良好亚组(P<0.05);Logistic回归分析,在校正年龄、糖尿病等其他因素前后,血清IL-12P70、4-HNE、S100A12均是老年CAP患者预后的独立影响因素(P<0.05);ROC曲线分析,血清IL-12P70、4-HNE、S100A12预测老年CAP预后的AUC为0.796、0.730、0.783,最佳截断值为5.24pg/mL、21.23mg/L、23.70ng/mL,敏感度为66.67%、63.64%、81.82%,特异度为82.40%、74.40%、68.80%;联合预测老年CAP预后的AUC为0.911,敏感度为84.85%,特异度为80.80%,较单独预测效能显著提高(Z=2.377、2.850、2.685,P=0.018、0.004、0.007);另选取同期老年CAP患者68例作为外部验证数据集样本,其中重症46例,非重症22例,随访28d,预后不良13例,预后良好55例。血清IL-12P70、4-HNE、S100A12联合预测外部验证数据集样本中68例患者预后情况为预后不良11例,预后良好57例,准确率为97.06%,提示预测效能较好。结论: 血清IL-12P70、4-HNE、S100A12与老年CAP患者病情严重程度呈正相关,是预后的独立影响因素,联合检测能较为准确地预测预后情况。

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关键词 ：社区获得性肺炎, 老年, 白细胞介素-12P70, 4-羟基壬烯醛, 钙结合蛋白S100A12

Abstract：Objective: To investigate the correlation between the levels of serum interleukin-12P70 (IL-12P70), 4-hydroxynonenal (4-HNE), and Calcium-binding protein (S100A12) in elderly patients with community-acquired pneumonia (CAP) and the severity and prognosis of the disease. Methods: A total of 158 elderly patients with CAP admitted to Hebei Chest Hospital from Apr. 2022 to Jun. 2024 were selected as the study group, and another 158 healthy physical examination subjects were selected as the control group. the levels of serum IL-12P70, 4-HNE, S100A12, pulmonary infection score (CPIS), acute physiology and chronic health evaluation II (APACHE II)score and pulmonary function indices [force expiratory volume in the first second (FEV1), and forceful lung capacity (FVC)] were compared in patients with different disease severity of the study group and control group. The correlation between serum levels of IL-12P70, 4-HNE, and S100A12 and the severity score of the disease was analyzed. The study group was followed up for 28 days and assigned to a good prognosis subgroup and a poor prognosis subgroup based on prognosis. The clinical data, serum levels of IL-12P70, 4-HNE, and S100A12 were compared between the two subgroups. The correlation and predictive efficacy of serum IL-12P70, 4-HNE, and S100A12 with prognosis were analyzed. Results: The levels of serum IL-12P70, 4-HNE, and S100A12 in the study group were higher than those in the control group (P<0.05). The levels of CPIS, APACHE II score, serum IL-12P70, 4-HNE, and S100A12 in severe patients were higher than those in non-severe patients, FEV1 and FVC were lower than non-severe patients (P<0.05). Pearson correlation analysis showed that serum IL-12P70, 4-HNE, and S100A12 were positively correlated with CPIS and APACHE II scores, negatively correlated with FEV1 and FVC(P<0.05). After a follow-up of 28 days, 33 patients in the study group had a poor prognosis and 125 patients had a good prognosis, which were included in the poor prognosis subgroup and the good prognosis subgroup, respectively. The age, proportion of severe cases, proportion of diabetes, CPIS, APACHE II score, serum IL-12P70, 4-HNE, and S100A12 levels in the poor prognosis subgroup were higher than those in the good prognosis subgroup,while FEV1 and FVC were lower than good prognosis subgroup (P<0.05). Logistic regression analysis showed that serum IL-12P70, 4-HNE, and S100A12 were independent factors affecting prognosis for elderly CAP patients before and after adjusting for age, diabetes, and other factors (P<0.05). ROC curve analysis showed that the AUC of serum IL-12P70, 4-HNE, and S100A12 for predicting the prognosis of elderly CAP was 0.796, 0.730, and 0.783, respectively. The optimal cutoff values were 5.24 pg/mL, 21.23 mg/L, and 23.70 ng/mL, with sensitivities of 66.67%, 63.64%, and 81.82%, and specificities of 82.40%, 74.40%, and 68.80%, respectively. The AUC of the combined prediction of the prognosis of elderly CAP was 0.911, with a sensitivity of 84.85% and a specificity of 80.80%, which was significantly improved compared with the prediction performance of individual factors (Z=2.377, 2.850, 2.685, P=0.018, 0.004, 0.007). Another 68 cases of elderly CAP patients in the same period were selected as the sample of external validation data set, of which 46 cases were severe and 22 cases were non-severe, with 28 days of follow-up, and 13 cases of poor prognosis and 55 cases of good prognosis. Serum IL-12P70, 4-HNE, and S100A12 combined to predict the prognosis of the 68 patients in the external validation data set sample was 11 cases of poor prognosis and 57 cases of good prognosis, with an accuracy of 97.06%, suggesting that the prediction efficiency was good. Conclusion: Serum IL-12P70, 4-HNE, and S100A12 are positively correlated with the severity of disease in elderly patients with CAP and are independent factors affecting prognosis. Combined detection can accurately predict the prognosis.

Key words： Community-acquired pneumonia Elderly Interleukin-12P70 4-Hydroxynonenal Calcium-binding protein S100A12

基金资助:河北省医学科学研究课题计划资助,(编号20250841)

通讯作者: 张静

引用本文:

刘月桥, 张明洋, 吴文燕, 张静. 老年社区获得性肺炎患者血清IL-12P70 4-HNE S100A12水平与病情严重程度及预后的相关性分析[J]. 河北医学, 2025, 31(5): 749-755.
LIU Yueqiao, et al. Correlation Analysis of Serum IL-12P70 4-HNE and S100A12 Levels with Severity and Prognosis of the Disease in Elderly Patients with Community-Acquired Pneumonia. HeBei Med, 2025, 31(5): 749-755.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.05.08 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I5/749

[1] Martin-Loeches I,Torres A,Nagavci B,et al.ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia[J].Intensive Care Med,2023,49(6):615-632.
[2] Sathitakorn O,Chansirikarnjana S,Jantarathaneewat K,et al.The role of procalcitonin and clinical pulmonary for infection score (CPIS) score to reduce inappropriate antibiotics use among moderate to severe coronavirus disease 2019 (COVID-19) pneumonia:a quasi-experimental multicenter study[J].Infect Control Hosp Epidemiol,2023,44(7):1199-1203.
[3] Posseme C,Llibre A,Charbit B,et al.Early IFNβ secretion determines variable downstream IL-12p70 responses upon TLR4 activation[J].Cell Rep,2022,39(13):110989.
[4] Xia PP,Ji XD,Yan L,et al.Roles of S100A8,S100A9 and S100A12 in infection,inflammation and immunity[J].Immunology,2024,171(3):365-376.
[5] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.成人社区获得性肺炎基层诊疗指南(2018年)[J].中华全科医师杂志,2019,18(2):117-126.
[6] 宋维,许和平.急诊成人社区获得性肺炎的病情判断与分级[J].中国急救医学,2012,32(7):577-578.
[7] 蔡剑英,陶学芳,王国文,等.重症肺炎患者血清IL-17及IL-12P70与CD64表达水平及其与预后的关系[J].中华医院感染学杂志,2024,34(16):2452-2456.
[8] Munitz A,Edry-Botzer L,Itan M,et al.Rapid seroconversion and persistent functional IgG antibodies in severe COVID-19 patients correlates with an IL-12p70 and IL-33 signature[J].Sci Rep,2021,11(1):3461.
[9] Hsu CG,Chavez CL,Zhang C,et al.The lipid peroxidation product 4-hydroxynonenal inhibits NLRP3 inflammasome activation and macrophage pyroptosis[J].Cell Death Differ,2022,29(9):1790-1803.
[10] 闻啟富,李新锋.重症肺炎患者血清4-HNE水平变化及其对临床诊疗和预后的评估价值[J].海南医学,2021,32(21):2755-2758.
[11] Zarkovic N,Orehovec B,Milkovic L,et al.Preliminary findings on the association of the lipid peroxidation product 4-hydroxynonenal with the lethal outcome of aggressive COVID-19[J].Antioxidants (Basel),2021,10(9):1341.
[12] Mester P,Keller D,Kunst C,et al.High serum S100A12 as a diagnostic and prognostic biomarker for severity,multidrug-resistant bacteria superinfection and herpes simplex virus reactivation in COVID-19[J].Viruses,2024,16(7):1084.
[13] 朱娅丽,杜维桓,张巍,等.老年重症社区获得性肺炎患者血清8-iso-PGF2α、S100 A12水平变化及临床意义[J].临床肺科杂志,2023,28(4):563-567.