Changes of interleukin-34 levels in serum and bronchoalveolar lavage fluid of patients with severe pneumonia and their prognostic value
Objective To investigate the changes in interleukin-34(IL-34)levels in serum and bronchoalveolar lavage fluid(BALF)of patients with severe pneumonia and their prognostic value.Methods A total of 66 patients with severe pneumonia(severe pneumonia group),35 patients with non-severe pneumonia(non-severe pneumonia group),and 27 healthy adults(control group)were en-rolled.The severe pneumonia group was further divided into suivival group of 38 patients and non-sur-vival group of 28 patients based on 28-day survival.Clinical data of all subjects were analyzed.Receiver operating characteristic(ROC)curves were plotted to assess the predictive power of serum IL-34 and relative IL-34 gene expression in BALF for 28-day mortality in patients with severe pneumonia,as well as the predictive power of serum IL-34 for severe pneumonia.Kaplan-Meier survival curves were plotted,and the Log-rank test was used to compare cumulative survival rates.Cox regression a-nalysis was conducted to explore risk factors for 28-day mortality in patients with severe pneumonia.Pearson correlation analysis was used to assess the correlation between serum IL-34 levels and rela-tive IL-34 gene expression in BALF of patients with severe pneumonia.Results Serum IL-34 levels were higher in the severe pneumonia group than those in the non-severe pneumonia group,and were higher in the non-severe pneumonia group than in the control group(P＜0.05).Serum IL-34 levels and relative IL-34 gene expression in BALF were higher in the non-survival group than in the surviv-al group(P＜0.05).ROC curve analysis showed that the areas under the curve for predicting 28-day mortality in patients with severe pneumonia were 0.908 for serum IL-34 levels and 0.878 for relative IL-34 gene expression in BALF.The optimal cutoff value for serum IL-34 levels in predic-ting severe pneumonia was 129.9 μg/mL.Multivariate Cox regression analysis showed that increased serum IL-34 levels and increased relative IL-34 gene expression in BALF were independent risk fac-tors for 28-day mortality in patients with severe pneumonia(P＜0.05).The Kaplan-Meier survival analysis results indicate that,with a cutoff value of 129.9 μg/mL,patients with severe pneumonia who had high serum levels of IL-34 exhibited a lower cumulative survival rate compared to those with low IL-34 level(Log-rank P＜0.001).Conclusion Serum IL-34 levels are significantly increased in patients with severe pneumonia,and relative IL-34 gene expression in BALF is positively correla-ted with serum IL-34 levels.Both can be used as indicators for predicting the prognosis of 28-day mortality in patients with severe pneumonia.
severe pneumoniabronchoalveolar lavage fluidinterleukin-34prognosis
万方数据
维普
