Correlation analysis of serum sCD14-ST and ACTA expression with disease and prognosis in elderly patients with chronic heart failure combined with pulmonary infection
Objective To investigate the expression of soluble leukocyte differentiation antigen 14 subtype(sCD14-ST)and activator of activated cellular triggering agent A(ACTA)in the sera of elderly patients with chronic heart failure(CHF)combined with pulmonary infection(PI),as well as its correlation with the patients'conditions and prognosis.The correlation with the patient's condition and prognosis.Methods Ninety-eight elderly patients with CHF combined with PI treated in the Geriatrics Department of the First Affiliated Hospital of Naval Medical University from January 2019 to March 2023 were the study subjects(PI group),and they were categorized into mild subgroups according to the severity of PI(n=41),moderate subgroup(n=32),and severe subgroup(n=25);and then according to the survival of patients dis-charged from the hospital for 28 d,they were categorized into the survival subgroup(n=66)and death subgroup(n=32);another 98 cases of elderly CHF patients with uncomplicated PI who had the same basic clinical data as the PI group in the same period were selected as controls(non-PI group).We compared the expression levels of serumsCD14-ST and ACTA in each group;analyzed the influencing factors on the prognosis of elderly CHF patients with PI by multifactorial logistic re-gression;and analyzed the predictive value of serum sCD14-ST and ACTA levels on the prognosis of elderly CHF patients with PI by ROC curve.Results SerumsCD14-ST and ACTA levels were elevated in the PI group compared with the non-PI group(t/P=34.065/<0.001,38.096/<0.001).Serum sCD14-ST,ACTA levels were increased in the mild subgroup,moder-ate subgroup,and severe subgroup of elderly patients with CHF combined with PI in that order(F/P=130.716/<0.001,152.476/<0.001).The proportion of patients with cardiac function class IV,sCD14-ST,and ACTA levels were higher in the death subgroup than in the survival subgroup(χ2/t/P=13.399/0.001,7.867/<0.001,7.297/<0.001).The results of multifac-torial logistic regression analysis showed that high cardiac function class,high sCD14-ST,and high ACTA were prognostic risk factors for elderly patients with CHF combined with PI[OR(95%CI)=2.723(1.355-5.471),3.154(1.626-6.117),3.425(1.678-6.990)].The AUCs of serum sCD14-ST,ACTA and the combination of the two for predicting prognosis in elderly patients with CHF combined with PI were 0.898,0.893 and 0.964,respectively,and the combination of the two was superior to their respective individual predictive efficacy(Z=2.281,2.882,P=0.023,0.004).Conclusion Serum sCD14-ST and ACTA levels were significantly elevated in elderly patients with CHF combined with PI,in order of severity,and the expression lev-els in the death subgroup were significantly higher than those in the survival subgroup,and the combination of the two had a high predictive value for the prognosis of elderly patients with CHF combined with PI.
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