Changing profiles and prognostic value of serological biomarkers in cases of severe pneumonia caused by different pathogens
10.16718/j.1009-7708.2025.04.006
- VernacularTitle:血清学指标在不同病原体感染重症肺炎患者中的变化及对预后的预测价值
- Author:
Ying CUI
1
;
Yan SHEN
1
Author Information
1. 无锡市锡山人民医院急诊科,江苏无锡 214105
- Publication Type:Journal Article
- Keywords:
serological biomarker;
pathogen;
severe pneumonia;
prognosis;
prognostic value
- From:
Chinese Journal of Infection and Chemotherapy
2025;25(4):393-400
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the changing profiles and prognostic value of serological biomarkers in patients with severe pneumonia caused by different pathogens.Methods A total of 164 patients diagnosed with severe pneumonia in Xishan People's Hospital from July 2022 to April 2024 were enrolled.The patients were assigned to bacterial infection group(n=64),Mycoplasma infection group(n=47),or viral infection group(n=53).The patients were also stratified into survivor group(n=107)or death group(n=57)according to outcomes.F test,t-test and Chi-square test were used to analyze the demographic data,symptoms,vital signs,and serological biomarkers in different groups.Multivariate Cox proportional hazards model was constructed to predict the poor prognosis of severe pneumonia.Goodness-of-fit test was performed,and the receiver operating characteristic curve(ROC)was used to evaluate the performance of the model.The locally weighted regression(LOWESS)was used to analyze the correlation between platelet-to-lymphocyte ratio(PLR)and clinical pulmonary infection score(CPIS).The restricted cubic spline(RCS)model was constructed to analyze the dose-response relationship between PLR and the risk of adverse outcome of severe pneumonia.Results The clinical pulmonary infection score(CPIS),white blood cell count(WBC),platelet count(PLT),lymphocyte(LYM),neutrophil(NEU),PLR,neutrophil-lymphocyte ratio(NLR),C-reactive protein(CRP),procalcitonin(PCT)and serum amyloid-like protein A(SAA)showed significant differences between the patients caused by bacterial infection,Mycoplasma infection or viral infection(P＜0.05).The CPIS score,WBC,LYM,PLR,NLR,CRP and SAA were significantly different between survivors and deaths(P＜0.05).Multivariate Cox proportional hazards model analysis showed that CPIS score,NLR,CRP,SAA and PLR were risk factors for poor prognosis in patients with severe pneumonia(P＜0.05).The model incorporating PLR for poor prognosis had better Hosmer-Lemeshow goodness of fit,larger AUC value and better diagnostic efficiency for patients with severe pneumonia.The LOWESS analysis showed nonlinear relationship between PLR and CPIS score to some extent.RCS model analysis showed that there was a nonlinear dose-response relationship between PLR and the risk of poor outcome in patients with severe pneumonia(P for nonlinear=0.048＜0.05).Conclusions PLR is significantly different between patients with severe pneumonia caused by different pathogens.PLR-containing biomarker panel can improve the diagnostic performance of severe pneumonia.
