结核与肺部疾病杂志2025，Vol.6Issue(4)：426-431,6.DOI:10.19983/j.issn.2096-8493.20250032
血清可溶性程序性死亡受体1与重症监护病房中肺结核患者病情及预后的关系研究
Study on the correlation between serum soluble PD-1 and the severity and prognosis of pulmonary tuberculosis patients in ICU
摘要
Abstract
Objective:To evaluate the value of serum soluble programmed death receptor-1(PD)-1 in assessing prognosis of the patients with pulmonary tuberculosis(PTB)in intensive care unit(ICU).Methods:A total of 102 pulmonary tuberculosis patients admitted to the ICU of Hebei Provincial Chest Hospital from April 2022 to April 2024 were included in this study,and they were divided into survival group and death group respectively,according to their survival status after 28 days in ICU.The serum soluble PD-1 levels of the patients in the two groups were compared,and its correlation with the severity,prognosis score and nutritional indicator of pulmonary tuberculosis patients in ICU was analyzed.Receiver operating characteristic(ROC)curve analysis was used to analyze the value of serum soluble PD-1 in assessing prognosis of the patients with pulmonary tuberculosis in ICU.Results:Among the 102 pulmonary tuberculosis patients in ICU who were included in this study,42 patients died(death group)with the case fatality rate of 41.2％(42/102),and 60 patients survived(survival group)with the survival rate of 58.8％(60/102).Compared with the patients in the survival group,the serum PD-1 level increased significantly among those patients in the death group(PD-1(pg/ml):47.25(41.48,51.15)vs.35.45(28.40,41.80),Z=-6.399,P＜0.001).PD-1 level was positively correlated with APACHE Ⅱ and SOFA scores(r=0.580,P＜0.001;r=0.575,P＜0.001),negatively correlated with prealbumin level(r=-0.297,P=0.002),and not correlated with lactate level(r=0.104,P=0.297).The results of ROC curve analysis showed that the area under the ROC curve(AUC)of PD-1 in predicting death of pulmonary tuberculosis patients after entering ICU 28 days was 0.873(95％CI:0.809-0.938).The optimal cutoff value of serum PD-1 was 38.45 pg/ml,with the sensitivity and the specificity were 95.2％and 65.0％respectively.While PD-1 value was combined with APACHEⅡ,the sensitivity was more than 99.9％and the specificity was 76.7％.Conclusion:The serum soluble PD-1 level is significantly increased in the death patients with pulmonary tuberculosis in ICU.Serum soluble PD-1 has certain clinical value in evaluating the severity and prognosis of tuberculosis patients admitted to the ICU.关键词
重症监护病房/结核,肺/程序性死亡受体-1/预后Key words
Intensive care units/Tuberculosis,pulmonary/Programmed cell death 1 receptor/Prognosis分类
医药卫生引用本文复制引用
魏云霞,王鑫,林红霞,李义帅..血清可溶性程序性死亡受体1与重症监护病房中肺结核患者病情及预后的关系研究[J].结核与肺部疾病杂志,2025,6(4):426-431,6.基金项目
河北省医学科学研究重点课题计划(20231215)Medical Science Research Project of Hebei Province(20231215) （20231215）
