检验医学与临床2025，Vol.22Issue(18)：2475-2480,6.DOI:10.3969/j.issn.1672-9455.2025.18.005
25-(OH)D3、pro-ADM、CD54在老年慢性心力衰竭并发肺部感染患者血清中的水平及与病原菌、预后的关系
Serum 25-(OH)D3,pro-ADM and CD54 levels and their associations with pathogens and prognosis in elderly patients with chronic heart failure and pulmonary infection
摘要
Abstract
Objective To investigate the associations between serum 25-hydroxyvitamin D3[25-(OH)D3],proadrenomedullin(pro-ADM),intercellular adhesion molecule-1(CD54)levels and pathogen profiles and prognosis in elderly patients with chronic heart failure(CHF)complicated by pulmonary infection(PI).Meth-ods A prospective cohort of 240 elderly CHF patients treated at the hospital from January 2022 to January 2023 was enrolled and divided into the PI-complicated group(96 cases)and non-PI group(144 cases)based on PI status.The PI-complicated group was further stratified into the death group and survival group according to 28 d hospitalization outcomes.Pathogen profiles were identified using standard microbiological methods,while serum levels of 25-(OH)D3,pro-ADM and CD54 were measured via enzyme-linked immunosorbent assay(ELISA).Multivariate Logistic regression was performed to identify prognostic factors in PI-complicated CHF patients.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the predictive value of serum 25-(OH)D3,pro-ADM and CD54 for mortality in this population.Results Serum 25-(OH)D3 level was significantly lower in the PI-complicated group than that in the non-PI group,while pro-ADM and CD54 levels were significantly higher than those in the non-PI group,with statistically significant differences(P＜0.05).Compared with patients having PI caused by gram-positive bacteria or fungi,25-(OH)D3 level was significantly lower and pro-ADM/CD54 levels were significantly higher in gram-negative bacterial PI patients,with statistically significant differences(P＜0.05).Statistically significant differences were observed in cardi-ac function classification,serum 25-(OH)D3,pro-ADM and CD54 levels between the death group and survival group(P＜0.05).Multivariate Logistic regression demonstrated that NYHA class,pro-ADM,CD54 and 25-(OH)D3 were influencing factor for mortality in elderly CHF patients with PI(P＜0.05).For predicting 28 d mortality,the areas under the ROC curve were 0.750 for 25-(OH)D3,0.772 for pro-ADM and 0.744 for CD54;the combined model of the three biomarkers yielded an AUC of 0.883,which was significantly greater than that of any individual biomarker(Zcombined vs.25-(OH)D3=2.225,P=0.026;Zcombined vs.pro-ADM=2.099,P=0.036;Zcombined vs.CD54=2.318,P=0.020).Conclusion Serum 25-(OH)D3 level was significantly reduced whereas pro-ADM and CD54 levels were elevated in elderly CHF patients complicated by PI.These biomarker levels varied significantly across pathogen types.The combined detection of serum 25-(OH)D3,pro-ADM and CD54 demonstrates significant predictive value for mortality in this population.关键词
25-羟基维生素D3/肾上腺髓质素前体/细胞间黏附分子-1/心力衰竭/肺部感染Key words
25-hydroxyvitamin D3/proadrenomedullin/intercellular adhesion molecule-1/heart fail-ure/pulmonary infection分类
医药卫生引用本文复制引用
李佳红,谭化,赵雅丽,张秀敬,贾营..25-(OH)D3、pro-ADM、CD54在老年慢性心力衰竭并发肺部感染患者血清中的水平及与病原菌、预后的关系[J].检验医学与临床,2025,22(18):2475-2480,6.基金项目
河北省2024年度医学科学研究课题(20242374). （20242374）
