| 史文俊.血清ANGPTL4联合PCT/SDI比值可预测重症细菌性肺炎患者的预后[J].内科急危重症杂志,2026,32(5):460-464 |
| 血清ANGPTL4联合PCT/SDI比值可预测重症细菌性肺炎患者的预后 |
| Serum ANGPTL4 combined with PCT/SDI ratio can predict the prognosis of patients with severe bacterial pneumonia |
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| DOI：10.11768/nkjwzzzz.202503260400 |
| 中文关键词: 重症细菌性肺炎 血管生成素样蛋白4 降钙素原 肺泡灌洗液辛普森菌群多样性指数 预后 预测 |
| 英文关键词: Severe bacterial pneumonia Angiopoietin -like protein 4 Procalcitonin Bronchoalveolar lavage fluid Simpsondiversity index Prognosis Prediction |
| 基金项目:河北省重点研发计划项目（22009310209D） |
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| 中文摘要: |
| 摘要 目的：探讨血清血管生成素样蛋白4（ANGPTL4）、降钙素原（PCT）/肺泡灌洗液辛普森菌群多样性指数（SDI）比值联合检测对重症细菌性肺炎患者预后的预测价值。方法：选取120例重症细菌性肺炎患者，根据30d预后分为预后良好组（88例）和预后不良组（32例）。比较2组患者临床资料、血清ANGPTL4、PCT/SDI比值。采用二列相关性分析血清ANGPTL4、PCT/SDI比值与预后的相关性；受试者工作特征（ROC）曲线分析血清ANGPTL4、PCT/SDI比值对预后的预测价值及其在预后中的交互效应。结果：预后不良组血清ANGPTL4、PCT水平及PCT/SDI比值高于预后良好组，SDI低于预后良好组（P均＜0.05）；血清ANGPTL4、PCT、PCT/SDI比值与预后呈正相关，SDI与预后呈负相关（P均＜0.05）；校正糖尿病、机械通气、急性生理学与慢性健康状况评估（APACHEⅡ）评分、氧合指数等因素后，血清ANGPTL4、PCT/SDI比值仍是预后的独立影响因素（P均＜0.05）；血清ANGPTL4、PCT/SDI比值联合预测预后的AUC高于各指标单独预测（P均＜0.05）；血清ANGPTL4阳性表达、PCT/SDI比值阳性表达在预后不良风险中呈正向交互作用。结论：重症细菌性肺炎预后不良患者血清ANGPTL4水平、PCT/SDI比值在预后不良风险中呈正向交互作用，联合检测其水平对预后具有较高的预测效能。 |
| 英文摘要: |
| Abstract Objective: To explore the predictive value of combined detection of serum angiopoietin-like protein 4 (ANGPTL4) and the ratio of procalcitonin (PCT) to bronchoalveolar lavage fluid Simpsondiversity index (SDI) for the prognosis of patients with severe bacterial pneumonia. Methods: A total of 120 patients with severe bacterial pneumonia were enrolled and divided into the good prognosis group (88 cases) and poor prognosis group (32 cases) based on 30-day prognosis. Clinical data, serum ANGPTL4 and PCT/SDI ratio were compared between the two groups. Bivariate correlation analysis was used to assess the correlation between serum ANGPTL4, PCT/SDI ratio and prognosis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the prognostic predictive value of serum ANGPTL4 and PCT/SDI ratio as well as their interaction effect. Results: Serum ANGPTL4, PCT levels and PCT/SDI ratio in the poor prognosis group were higher than those in the good prognosis group, while SDI was lower (all P< 0.05). Serum ANGPTL4, PCT and PCT/SDI ratio were positively correlated with poor prognosis, and SDI was negatively correlated with poor prognosis (all P< 0.05). After adjusting for diabetes mellitus, mechanical ventilation, acute physiological status and chronic health evaluation II (APACHE II) score, oxygenation index and other factors, serum ANGPTL4 and PCT/SDI ratio remained independent influencing factors for prognosis (all P< 0.05). The AUC of combined prediction by serum ANGPTL4 and PCT/SDI ratio was higher than that of each single indicator (all P< 0.05). Positive expression of serum ANGPTL4 and positive PCT/SDI ratio exhibited a positive interaction effect on the risk of poor prognosis. Conclusion: Elevated serum ANGPTL4 level and PCT/SDI ratio show a positive interaction effect on the risk of poor prognosis in patients with severe bacterial pneumonia. Combined detection of these two indicators has high prognostic predictive efficiency. |
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