SA A and endotoxin combined with SPA testing in the diagnosis and management of severe pneumonia
Objective To investigate the clinical significance of surfactant protein A(SPA),Se-rum amyloid A(SAA),endotoxin and surfactant protein A in patients with severe pneumonia.Methods 102 patients with severe pneumonia admitted to Huangshan Shoukang Hospital from January 2019 to December 2022 were selected as the study subjects.Additionally,95 patients with mild pneumonia during the same period and 96 healthy individuals who underwent physical examination during the same period were chosen as the se-vere pneumonia group(n=102),mild pneumonia group(n=95)and control group(n=96).The study involved comparing SAA,endotoxin,and SPA levels in 3 groups.Furthermore,a comparison of pneumonia severity in-dex(PSI)scores was conducted between the severe pneumonia group and the mild pneumonia group.The corre-lation of SAA,endotoxin and SPA levels with PSI scores was analyzed using Spearman's analysis.Patients in the severe pneumonia group were then divided into a good prognosis group and a poor prognosis group based on their prognosis.SAA,endotoxin,SPA levels and PSI scores were compared between the two groups.Factors af-fecting the prognosis of patients with severe pneumonia were analyzed.and the value of single and combined tests of SAA,endotoxin,and SPA levels in assessing the prognosis of severe pneumonia.Results SAA,endo-toxin,and SPA levels were found to be in the following order:severe pneumonia group>mild pneumonia group>control group.The PSI score also followed this trend:severe pneumonia group>mild pneumonia group,the differences were statistically significant(P<0.05).After Spearman's correlation analysis,it was determined that SAA,endotoxin,and SPA levels were positively correlated with PSI scores(r=0.653,0.682,and 0.734,P<0.05).In terms of prognosis,the 102 patients with severe pneumonia were divided into a good prognosis group(n=86)and a poor prognosis group(n=16).The SAA,endotoxin,SPA levels and PSI scores of the poor prognosis group were significantly higher than those of the good prognosis group(P<0.05).Logistic regression analysis showed that SAA,endotoxin,SPA levels,and PSI scores were independent predictors of poor progno-sis in patients with severe pneumonia(P<0.05).The AUC values for single SAA,endotoxin,SPA and the com-bination of the three for predicting the prognosis of patients with severe pneumonia were 0.712,0.705,0.764 and 0.957,respectively.The combination of the three had a significantly higher predictive value(P<0.05).Conclusion The levels of SAA,endotoxin,and SPA were all positively correlated with the severity of the patient's condition,making them valuable in the prognostic assessment of severe pneumonia.
Serum amyloid AEndotoxinLung surface-active protein Asevere pneumonia
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