血清肌酸激酶水平升高增加重症肺炎患者的死亡风险

张合.血清肌酸激酶水平升高增加重症肺炎患者的死亡风险[J].内科急危重症杂志,2025,31(5):440-444

DOI：10.11768/nkjwzzzz20250509

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作者	单位	E-mail
张合	南京医科大学附属常州市第二人民医院	506790708@qq.com

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中文摘要:

摘要目的：探讨血清肌酸激酶（CK）与重症肺炎患者预后的关系。方法：回顾性分析315例重症肺炎患者的临床资料。30d内死亡患者75例为死亡组，存活患者240例为生存组。采用受试者工作特征（ROC）曲线评估血清CK对重症肺炎的预测效能; Kaplan-Meier生存曲线分析不同血清CK水平患者的30d生存率; COX回归分析不同血清CK分层对死亡的风险因素。结果:死亡组患者血清CK水平明显高于生存组（342.0 U/L vs. 119.0 U/L, P<0.001）。ROC曲线分析显示血清CK对重症肺炎患者预后有预测价值（AUC=0.712），其临界值为253.5 U/L。Kaplan-Meier生存曲线分析显示高于临界值的患者30 d累积生存率更低（Log-Rank P<0.001）。血清CK分层显示随着血清CK水平升高，患者死亡风险增大。结论：血清CK可预测重症肺炎患者的预后，其水平升高预示患者死亡风险增加。

英文摘要:

Abstract Objective: To investigate the association between serum creatine kinase (CK) levels and prognosis in patients with severe pneumonia. Method: The clinical data of 315 patients with severe pneumonia were analyzed retrospectively. A total of 75 patients who died within 30 days were in the death group, and 240 patients who survived were in the survival group. The predictive efficacy of serum CK for severe pneumonia was evaluated using the receiver operating characteristic (ROC) curve. The 30-day survival rate of patients with different serum CK levels was analyzed using the Kaplan-Meier survival curve. The risk factors for death in different serum CK strata were analyzed using COX regression. Results: The CK level in the death group was significantly higher than that in the survival group (342.0 U/L vs. 119.0 U/L, P< 0.001). The ROC curve analysis demonstrated that serum CK had prognostic value for patients with severe pneumonia (AUC=0.712), with a cutoff value of 253.5 U/L. Kaplan-Meier survival analysis revealed that patients with serum CK levels above the cutoff had a significantly lower 30-day cumulative survival rate (log-rank P< 0.001). Stratified analysis of serum CK showed that as the serum CK level increased, the risk of patient death also increased. Conclusion: Serum CK is an independent predictor of prognosis in patients with severe pneumonia, and higher CK levels are associated with greater mortality risk.