摘要
目的探讨成纤维细胞生长因子21在重症社区获得性肺炎(Severe community-acquired pneumonia,SCAP)患者的表达与临床意义。方法选取2017年5月-2019年5月于合肥医科大学附属医院重症医学科收治的SCAP患者118例作为SCAP组,选择50名健康体检者作为对照组,分析SCAP组患者病原特点;采用酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)检测患者血清中成纤维细胞生长因子21(Fibroblast growth factor 21,FGF21)水平,比较两组不同肺炎程度评分(Pneumonia severity index,PSI)、CURB评分FGF21水平,分析FGF21浓度与PSI、CURB评分、体温、空腹血糖相关性,采用受试者工作特征曲线(Receiver operating characteristic curve,ROC)对FGF21、降钙素原(Procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)和白细胞计数(White blood cell,WBC)评价SCAP患者的不良结局的预测价值。结果SCAP组118例患者共检出病原80株,主要以流感病毒、铜绿假单胞菌、嗜肺军团菌、金黄色葡萄球菌、肺炎支原体为主;SCAP组FGF21水平(851.77±283.15)pg/ml高于对照组(76.80±21.93)pg/ml(P<0.001);FGF21在PSI分级IV^V级患者浓度高于I^III级患者(P<0.001),二者相关系数为0.321(P=0.021);FGF21浓度随CRUB评分增加而不断升高(P<0.001),二者相关系数为0.253(P=0.045);ROC分析结果显示,FGF21对SCAP患者不良预后的预测价值高于PCT、CRP、WBC。结论FGF21与SCAP患者病情严重程度正相关,可作为临床病情判断及预后评估的参考指标。
OBJECTIVE To investigate the expression and clinical significance of fibroblast growth factor 21 in patients with severe community acquired pneumonia.METHODS From May 2017 to May 2019,118 SCAP patients admitted to the department of intensive medicine of the Affiliated Hospital of Zunyi Medical University were recruited in the SCAP group and 50 healthy people with physical examination were in the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect the level of fibroblast growth factor 21(FGF21)in the serum of patients.Pneumonia severity index(PSI),CURB score and FGF21 level were compared between the two groups.The correlation between FGF21 and PSI,CURB score,body temperature and fasting blood glucose were evaluated.Receiver operating characteristic curve(ROC)was used to assess the clinical value of indexes of FGF21,procalcitonin(PCT),C-reactive protein(CRP)and white blood cell count(WBC)in the prediction of the adverse outcomes in SCAP patients.RESULTS Total of 80 strains of pathogens were detected in 118 patients of the SCAP group,mainly including influenza virus,Pseudomonas aeruginosa,Legionella pneumophila,Staphylococcus aureus,and Mycoplasma pneumoniae.FGF21 level in the SCAP group was(851.77±283.15)pg/ml,which was significantly higher than that in the control group with(76.80±21.93)pg/ml(P<0.001).The concentration of FGF21 in patients with PSI grade IV to V was significantly higher than that in patients with grade I to III(P<0.001);the correlation coefficient between the two was 0.321(P=0.021).The concentration of FGF21 increased significantly with the improvement of CRUB score(P<0.001);the correlation coefficient between the two was 0.253(P=0.045).ROC analysis showed that the predictive value of FGF21 for the prediction of poor prognosis of SCAP was higher than that of PCT,CRP and WBC.CONCLUSION FGF21 was positively correlated with the severity of severe community acquired pneumonia,which can be used as a reference for clinical disease diagnosis and prognosis evaluation.
作者
李康
陈淼
梅鸿
覃松
魏珩
LI Kang;CHEN Miao;MEI Hong;TAN Song;WEI Heng(Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563003,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第15期2292-2295,共4页
Chinese Journal of Nosocomiology
基金
贵州省科研基金资助项目(20183017)。
