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| Relationship between Serum SAA PCT FN RBP and Disease Severity Prognosis in Elderly Patients with Pneumonia |
| WANG Lianghui, MA Di, YIN Jun, et al |
| The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui Hefei 230031, China |
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Abstract Objective: To analyze the relationship between serum amyloid a (SAA), procalcitonin (PCT), plasma fibronectin (FN), retinol binding protein (RBP) and disease severity, prognosis in elderly patients with pneumonia.Methods: A retrospective analysis was performed on the clinical data of 85 elderly patients with pneumonia in the hospital between April 2021 and April 2024. According to prognosis, patients were divided into good prognosis group (60 cases) and poor prognosis group (25 cases). After admission, levels of blood indexes [PCT, SAA, RBP, hemoglobin (Hb), FN, albumin (ALB), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), β2 microglobulin], hemocytes [white blood cell count (WBC), neutrophil ratio, lymphocyte ratio, platelets] and blood gas indexes [partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), bicarbonate ion concentration (HCO3-), base excess (BE), blood lactate concentration (Lac)], and scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) were compared between the two groups. The correlation between blood indexes and APACHE Ⅱ score was analyzed by Spearman correlation analysis. The blood indexes affecting the prognosis of elderly patients with pneumonia were analyzed with Logistic regression analysis. The prognostic value of relevant indexes was analyzed with ROC curves.Results: The levels of PCT, SAA, IL-6, hs-CRP, RBP and β2 microglobulin in the poor prognosis group were higher than those in the good prognosis group, and the levels of ALB and FN were lower than those in the good prognosis group (P<0.05). APACHE Ⅱ score was higher in poor prognosis group (P<0.05). The results of Spearman correlation analysis showed that levels of serum PCT, SAA and RBP were positively correlated with APACHE Ⅱ score, while FN level was negatively correlated with it (P<0.05). The results of Logistic regression analysis showed that serum PCT, SAA, FN and RBP were all influencing factors of prognosis in elderly patients with pneumonia (P<0.05). The results of ROC curves analysis showed that serum PCT (AUC=0.819), SAA (AUC=0.775), FN (AUC=0.792) and RBP (AUC=0.736) were all of good predictive value in prognosis of elderly patients with pneumonia (P<0.05).Conclusion: The higher the levels of serum SAA, PCT and RBP, and the lower the FN level, the severer the disease and the worse the prognosis in elderly patients with pneumonia, and all the above four indexes have good prognostic value for elderly patients with pneumonia.
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[1] 余小丽,陈愉生,俞婷.194例老年CAP患者合并呼吸道病毒感染情况分析[J].山东医药,2024,64(18):31-34.
[2] Khadka S,Khan S,King A,et al.Poor oral hygiene,oral microorganisms and aspiration pneumonia risk in older people in residential aged care:a systematic review[J].Age and Ageing,2021,50(1):81-87.
[3] 中华医学会呼吸病学分会.中国成人CAP诊断和治疗指南(2016年版)[J].中华结核和呼吸杂志,2016,39(4):253-279.
[4] 陈灏珠.实用内科学[M].第12版.北京:人民卫生出版社,2005.59-69.
[5] Olson G,Davis A M.Diagnosis and treatment of adults with community-acquired pneumonia[J].Jama,2020,323(9):885-886.
[6] 商娜,李秋敬,刘慧珍,等.基于老年综合征构建急诊老年肺炎合并脓毒症患者28d死亡预测模型并验证[J].中华老年多器官疾病杂志,2024,23(6):460-465.
[7] 杨建章,邓克廷.外周血中CRP、SAA、PCT在老年吸入性肺炎患者中的表达水平及临床意义[J].贵州医药,2024,48(6):884-886.
[8] 吴瑕,葛红庭,王君,等.血清胆碱酯酶和视黄醇结合蛋白联合检测对呼吸机相关性肺炎临床诊断价值分析[J].临床肺科杂志,2024,29(2):189-194.
[9] 李娜.老年重症肺炎患者炎症因子、D-dimer和血浆纤维结合蛋白动态监测的临床预后价值[J].临床研究,2022,30(2):40-43. |
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2024, Vol. 30 
