血清可溶性清道夫受体163、基质金属蛋白酶-9联合肺超声评分对呼吸机相关性肺炎的诊断价值
Diagnostic value of serum soluble scavenger receptor 163, matrix metalloproteinase-9 combined with lung ultrasound score for ventilator-associated pneumonia

黄鹂.血清可溶性清道夫受体163、基质金属蛋白酶-9联合肺超声评分对呼吸机相关性肺炎的诊断价值[J].内科急危重症杂志,2026,32(2):162-166

DOI：10.11768/nkjwzzzz20260212

中文关键词: 呼吸机相关性肺炎可溶性清道夫受体163 基质金属蛋白酶 9 肺超声评分诊断

英文关键词:

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作者	单位	E-mail
黄鹂		1142184443qq.com

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中文摘要:

摘要目的：探究血清可溶性清道夫受体163（sCD163）、基质金属蛋白酶-9（MMP-9）联合肺超声评分（LUS）对呼吸机相关性肺炎（VAP）的诊断价值。方法：选取120例接受呼吸机通气治疗（＞48 h）的患者，根据治疗后是否发生VAP将其分成VAP组（62例）和非VAP组（58例）。采用酶联免疫吸附法检测患者血清sCD163、MMP-9水平；Pearson法分析血清sCD163、MMP-9与LUS、临床肺部感染评分（CPIS）相关性；多元Logistic回归分析发生VAP的影响因素；受试者工作特征（ROC）曲线分析血清sCD163、MMP-9联合LUS对VAP的诊断价值。结果：VAP组中出现肺实变伴支气管充气征58例（93.55%），肺间质综合征47例（75.81%），胸腔积液者20（32.26%）。VAP组CPIS、LUS以及血清sCD163、MMP-9水平明显高于非VAP组（P均＜0.05）。Pearson法分析显示，血清sCD163、MMP-9与LUS、CPIS呈正相关（P均＜0.05）；多因素Logistic回归分析结果显示，血清sCD163、MMP-9是影响VAP发生的危险因素（P均＜0.05）；ROC曲线分析显示，血清sCD163、MMP-9、LUS诊断VAP的曲线下面积（AUC）分别为0.756、0.758、0.712，三者联合诊断的AUC为0.867，三者联合优于单一诊断（Z联合 vs sCD163=2.037、Z联合 vs MMP-9=2.000、Z联合 vs LUS=2.745，P=0.042、0.045、0.006）。结论：VAP患者血清sCD163、MMP-9水平以及LUS均增加，三者联合检测对VAP诊断有较高的价值。

英文摘要:

Abstract Objective: To investigate the diagnostic value of serum soluble scavenger receptor 163 (sCD163), matrix metalloproteinase-9 (MMP-9), and lung ultrasound score (LUS) for ventilator-associated pneumonia (VAP). Methods: A total of 120 patients who received mechanical ventilation (> 48 h) were selected and divided into VAP group (62 cases) and non-VAP group (58 cases) according to whether VAP occurred after treatment. Enzyme linked immunosorbent assay was applied to detect serum sCD163 and MMP-9 levels in subjects. Pearson method was applied to analyze the correlation between serum sCD163, MMP-9, LUS, and clinical pulmonary infection score (CPIS) in subjects. Multiple logistic regression was applied to analyze the influencing factors of VAP. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of serum sCD163, MMP-9 combined with LUS for VAP. Results: In the VAP group, there were 58 cases (93.55%) of pulmonary consolidation with bronchial inflation syndrome, 47 cases (75.81%) of pulmonary interstitial syndrome, and 20 cases (32.26%) of pleural effusion. The CPIS, serum sCD163 and MMP-9 levels, and LUS in the VAP group were significantly higher than those in the non-VAP group (P< 0.05). Pearson analysis showed that serum sCD163 and MMP-9 levels were positively correlated with LUS and CPIS (P< 0.05). Multivariate logistic regression revealed that serum sCD163 and MMP-9 were risk factors affecting the occurrence of VAP (all P< 0.05). ROC curve analysis showed that the area under the curve (AUC) of serum sCD163, MMP-9, and LUS for diagnosing VAP were 0.756, 0.758, and 0.712, respectively, and the AUC of combined diagnosis of the three was 0.867, and the combined diagnosis of the three was better than a single diagnosis (Zcombination vs sCD163= 2.037,Zcombination vs MMP-9=2.000, Zcombination vs LUS=2.745; P=0.042, 0.045, 0.006). Conclusion: Serum sCD163 and MMP-9 levels, and LUS are increased in patients with VAP, and the combination of the three has a high value in the diagnosis of VAP.