Serum levels of DcR3,GDF-15,and HBP in elderly patients with severe pneumonia and respiratory failure and their eeffects on the condition and prognosis
Objective To investigate the serum levels of decoy receptor 3(DcR3),growth differentiation factor-15(GDF-15),and heparin binding protein(HBP)in elderly patients with severe pneumonia(SP)and respiratory failure(RF),and their evaluation value for the condition and prognosis.Methods A total of 128 elderly patients with SP and RF who were treated in our hospital from September 2020 to February 2022 were collected as the study subjects in the observation group,according to the severity of their condition,they were grouped into a low risk group of 42 cases,a medium risk group of 54 cases,and a high risk group of 32 cases,according to their prognosis,they were grouped into survival group(98 cases)and death group(30 cases);in addition,128 elderly SP patients without RF who were treated in our hospital were collected as the control group.Serum levels of DcR3,GDF-15,HBP,TNF-α,and IL-6 were measured by enzyme linked immunosorbent assay(ELISA);Pearson was applied to analyze the correlation between serum DcR3,GDF-15,HBP,TNF-α,IL-6,and APACHE Ⅱ score in elderly patients with SP and RF;multivariate Logistic regression was applied to analyze the influencing factors of death in elderly patients with SP and RF;the value of serum DcR3,GDF-15,and HBP levels in predicting the prognosis of elderly patients with SP and RF was evaluated using receiver operating characteristic curve(ROC).Results The levels of serum DcR3,GDF-15,and HBP in the observation group were obviously higher than those in the control group(P＜0.05);the serum levels of DcR3,GDF-15,and HBP in elderly patients with SP and RF gradually increased with the severity of the disease(P＜0.05);the levels of serum DcR3,GDF-15,HBP,TNF-α,IL-6,and APACHE Ⅱ score in elderly patients with SP and RF in the death group were obviously higher than those in the survival group(P＜0.05);Pearson correlation analysis showed that serum DcR3,GDF-15,and HBP levels in elderly patients with SP and RF were positively correlated with TNF-α,IL-6,and APACHE Ⅱ score(P＜0.05);multivariate Logistic regression analysis showed that high levels of DcR3,GDF-15,and HBP were independent risk factors for death in elderly patients with SP and RF(P＜0.05);ROC analysis showed that the area under curve(AUC)of serum DcR3,GDF-15,and HBP levels in predicting mortality in elderly patients with SP and RF was 0.843,0.841,and 0.804,respectively,the AUC predicted by the combination of the three methods was 0.943,which was better than single prediction(Z=2.258,2.303,2.653,P＜0.05).Conclusion The serum levels of DcR3,GDF-15,and HBP in elderly patients with SP and RF are obviously elevated,and they increase with the severity of their illness.The combination of the three has important value in predicting the prognosis of elderly patients with SP and RF.
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