河北医学2025，Vol.31Issue(5)：749-755,7.DOI:10.3969/j.issn.1006-6233.2025.05.08
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
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
摘要
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 da-ta,serum levels of IL-12P70,4-HNE,and S100A12 were compared between the two subgroups.The corre-lation and predictive efficacy of serum IL-12P70,4-HNE,and S100A12 with prognosis were analyzed.Re-sults: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 sub-group,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 ca-ses of good prognosis,with an accuracy of 97.06%,suggesting that the prediction efficiency was good.Con-clusion:Serum IL-12P70,4-HNE,and S100A12 are positively correlated with the severity of disease in eld-erly patients with CAP and are independent factors affecting prognosis.Combined detection can accurately pre-dict the prognosis.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S100A12Key words
Community-acquired pneumonia/Elderly/Interleukin-12P70/4-Hydroxynone-nal/Calcium-binding protein S100A12引用本文复制引用
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):749-755,7.基金项目
河北省医学科学研究课题计划资助,(编号20250841) （编号20250841）
