血浆内脂素浓度与社区获得性肺炎患者预后的相关分析

目的探讨社区获得性肺炎（CAP）患者血浆内脂素浓度对疾病预后的相关价值。方法收集112例健康体检者和112例CAP患者外周血样本，采用酶联免疫吸附试验法检测所有样本血浆内脂素浓度，分析CAP患者血浆内脂素浓度与动脉血氧分压、氧合指数、血白细胞计数、血浆c反应蛋白浓度、肺炎严重指数和急性病生理学和长期健康评价（APACHE）Ⅱ评分的相关程度，并进行Logistic回归分析。采用ROC曲线分析血浆内脂素浓度对CAP患者入院后30d内死亡的预测价值。结果CAP患者血浆内脂素浓度较健康体检者明显增高（t=19．538，P〈0．001）。CAP患者血浆内脂素浓度与动脉血氧分惬（r=-0．451，P〈0．05）、氧合指数（r=-0．473，P〈0．05）、血白细胞计数（r=0．412，P〈0．05）、血浆C-反应蛋白浓度（r=0．501，P〈0．05）、肺炎严重指数（r=0．541，P〈0．05）和APACHEⅡ评分（r=0．528，P〈0．05）均有显著相关。Logistic回归分析显示，血浆内脂素浓度（OR=1．242，95％CI=1．101～2．387，P〈0．001）、肺炎严重指数（OR=1．209，95％CI：1．081，-1．749，P〈0．001）及APACHEⅡ评分（OR=1．368，95％CI=1．107～2．023，P〈0．001）是CAP患者住院后30d内死亡的独立危险因素。ROC曲线分析显示，血浆内脂素浓度对CAP患者住院后30d内死亡有显著预测价值（曲线下面积为0．869，95％CI=0．792．0．925，P〈0．001）。结论内脂素参与社区获得性肺炎的全身炎症反应，血浆内脂素浓度与CAP的预后显著相关。

Correlative analysis of plasma visfatin for the prognosis of patients with community- acquired pneumonia

Objective To explore the correlative analysis of plasma visfatin for prognosis of patients with community-acquired pneumonia （CAP）. Methods The peripheral blood of 112 CAP patients and 112 normal healthy persons were e,rolled into this study. The levels of plasma visfatin in all cases were measured by enzyme-linked immunosorbent assay. The correlations of plasma visfatin in the CAP patients with arterial blood oxygen partial pressure, oxygen index, white blood cell count, plasma C-reactive protein concentration, pneumonia severity index score and acute physiology and chronic health evaluation （APACHE） Ⅱ score were evaluated and used by Logistic regression analysis. The receiver operating characteristic （ROC） curves was analyzed to predict the plasma visfatin for 30-day in-hospital mortality of CAP patients. Results The levels of plasma visfatin in the CAP patients were obviously higher than those in healthycontrols （t = 19.538, P 〈 0.001）. In the CAP patients, the level of plasma visfatin was highly associated with arterial blood oxygen partial pressure （r =-0.451, P 〈 0.05）, oxygen index （r = -0.473, P〈 0.05）, white blood cell count （r = 0.412, P〈 0.05）, plasma C-reactive protein （r = 0.501, P〈 0.05）, pneumonia severity index score （r = 0.541, P〈 0.05） and APACHE [I score （r = 0.528, P〈 0.05）. Logistic regression analysis showed that the independent factors contributing to 30-day in-hospital mortality of the CAP patients were plasma visfatin （OR： 1.242, 95%CI： 1.101 to 2.387, P〈0.001）, pneumonia severity index score （OR： 1.209, 95%CI： 1.081 to 1.749, P〈0.001）, and APACHE Ⅱ score （OR： 1.368, 95%CI： 1.107 to 2.023, P〈 0.001）. ROC analysis showed that plasmavisfatin obviously predicted 30-day in-hospital mortality of the CAP patients （area under curve： 0.869, 95%CI： 0.792 to 0.925, P 〈 0.001）. Conclusion Plasma visfatin is involve in systemic inflammatory response of CAP, and can be associated obviously with the prognosis of CAP.