Objective: To study the predictive effect of serum angiopoietin-2 on the condition of patients with community-acquired pneumonia, aiming to provide a scientific basis for early clinical intervention. Methods: From January 2020 to December 2021, 145 patients (81 males and 64 females) who met the diagnostic criteria of CAP (Community Acquired Pneumonia) were selected. A total of 145 patients were scored and divided into three groups according to the Pneumonia Severity Index (PSI), 72 cases in the low-risk group, 46 cases in the moderate-risk group and 27 cases in the high-risk group. Meanwhile, 70 people who had physical examination in the First People's Hospital of Zhengzhou City were selected as the control group. The medical records were checked to collect basic data of patients such as age, sex, body mass index, smoking history, drinking history, etc. Venous blood was collected on the day of admission (the day of physical examination in the control group) to measure the level of CRP (C-reactive protein), PCT (procalcitonin), TNF-α (tumor necrosis factor-α), Ang-2 (serum angiopoietin-2), WBC (white blood count), NLR (neutrophil to lymphocyte ratio), and PLR (platelet to lymphocyte ratio). Results: There was no significant difference in age, male proportion, BMI, smoking and drinking history between the groups of CAP patients and the control group (P＞0.05). Compared with the control group, the levels of CRP, PCT, TNF-α, Ang-2, WBC, NLR in CAP patients were significantly improved, and the difference was statistically significant (P＜0.05). With the aggravation of the condition of CAP patients, levels of CRP, PCT, TNF-α, Ang-2, WBC, NLR and PLR were significantly increased (P＜0.05). Correlation analysis results showed that the level of Ang-2 in patients was positively correlated with CRP, PCT, TNF-α, WBC, NLR, and PLR level (r=0.458 , 0.368, 0.481, 0.512, 0.419, 0.268) (P＜0.05). ROC analysis results indicated that when the optimal cutoff value of Ang-2 was 5.051, the area under the ROC curve was 0.689, the standard error was 0.023, 95 % CI (0.125-2.004), with the sensitivity of 75.32 % in predicting death of CAP patients and the specificity of 70.38 %. Conclusion: The Ang-2 level of CAP patients was significantly higher than that of the healthy people, and could be increased with the aggravation of CAP. The Ang-2 level was positively correlated with CRP, PCT, TNF- α, WBC, NLR and PLR, suggesting that the level of Ang-2 could be used to predict the condition of patients with CAP effectively.
[1] Cassiere HA, Niederman MS. Community-acquired pneumonia[J]. Dis Mon, 1998, 44(11): 613-675.
[2] Ramirez JA, Musher DM, Evans SE, et al. Treatment of community-acquired pneumonia in immunocompromised adults: a consensus statement regarding initial strategies[J]. Chest, 2020, 158(5): 1896-1911.
[3] 彭爱君, 许银苹, 张华, 等. 血红蛋白水平与老年社区获得性肺炎患者病情程度及预后的相关性分析[J]. 中国社区医师, 2019, 35(26): 105-106.
[4] 宋伟伟, 王宇, 王志勇, 等. 95岁及以上长寿老年人社区获得性肺炎住院转归的相关因素分析[J]. 中华老年医学杂志, 2019, 38(2): 113-118.
[5] Wang DW, Willis DR, Yih Y. The pneumonia severity index: assessment and comparison to popular machine learning classifiers[J]. Int J Med Inform, 2022, 163: 104778.
[6] Bradley J, Sbaih N, Chandler TR, et al. Pneumonia severity index and CURB-65 score are good predictors of mortality in hospitalized patients with SARS-CoV-2 community-acquired pneumonia[J]. Chest, 2022, 161(4): 927-936.
[7] Kurt E, Ak R, Eke Kurt SZ, et al. Prognostic utility of CURB-65 and E-CURB-65 scoring systems in healthcare associated pneumonia patients: short- and long-term mortality[J]. Niger J Clin Pract, 2021, 24(11): 1706-1711.
[8] Song Y, Sun WX, Dai DY, et al. Prediction value of procalcitonin combining CURB-65 for 90-day mortality in community-acquired pneumonia[J]. Expert Rev Respir Med, 2021, 15(5): 689-696.
[9] 韩振坤, 尹彦斌, 姜素文, 等. 血清Ang-2和PGRN与老年重症肺炎合并呼吸衰竭患者预后的关系[J]. 中国现代医学杂志, 2021, 31(21): 91-97.
[10] 董彩霞. 血清ANG2、PCT、SAA水平变化与慢性阻塞性肺疾病患者病情程度的关联性及临床意义探讨[J]. 现代医用影像学, 2018, 27(6): 2190-2191.
[11] 瞿介明, 曹彬. 中国成人社区获得性肺炎诊断和治疗指南(2016年版)修订要点[J]. 中华结核和呼吸杂志, 2016(4): 241-242.
[12] Martin-Loeches I, Torres A. New guidelines for severe community-acquired pneumonia[J]. Curr Opin Pulm Med, 2021, 27(3): 210-215.
[13] Rothberg MB. Community-acquired pneumonia[J]. Ann Intern Med, 2022, 175(4): ITC49-ITC64.
[14] Same RG, Amoah J, Hsu AJ, et al. The association of antibiotic duration with successful treatment of community-acquired pneumonia in children[J]. J Pediatric Infect Dis Soc, 2021, 10(3): 267-273.
[15] 门猛, 苗雅娇, 刘则林. 成人社区获得性肺炎严重程度及死亡危险因素分析[J]. 国际呼吸杂志, 2021(23): 1795-1800.
[16] 梅静, 杨进, 蒋建军, 等. 三种评分系统对重症社区获得性肺炎患者严重程度的预测价值[J]. 临床肺科杂志, 2018, 23(6): 1038-1042.
[17] 张颜苹, 霍建民, 陈晓灿. 成人社区获得性肺炎病情评估的研究进展[J]. 临床肺科杂志, 2020, 25(1): 143-146, 162.
[18] 姜琪, 邓丽娟, 张艳, 等. 特发性间质性肺炎急性加重期患者血清核心蛋白多糖、血管生成素-2的表达及临床意义[J]. 国际检验医学杂志, 2021, 42(8): 916-920.
[19] 徐竞, 李涛, 杨光明, 等. 血管生成素-2经肌内皮缝隙连接调节血管低反应性[J]. 中华实验外科杂志, 2018, 35(5): 832-834.
[21] 王敏, 郝明伟, 陈晓明, 等. 血清CC16、Ang-2水平对重症肺炎患者预后的预测价值[J]. 山东医药, 2021, 61(16): 11-15.
[22] 陈婷, 周小妹, 姚莉, 等. 血浆血管生成素-2、白细胞介素-8在重症社区获得性肺炎疾病严重程度及其预后评估中的价值[J]. 安徽医药, 2020, 24(3): 488-491, I0005.
[23] Wang YH, Zhang S, Li L, et al. The usefulness of serum procalcitonin, C-reactive protein, soluble triggering receptor expressed on myeloid cells 1 and Clinical Pulmonary Infection Score for evaluation of severity and prognosis of community-acquired pneumonia in elderly patients[J]. Arch Gerontol Geriatr, 2019, 80: 53-57.
[24] 安宏阳, 闫永会. 老年社区获得性肺炎患者血清CRP、PCT表达水平与预后的相关性分析[J]. 现代诊断与治疗, 2021, 32(3): 443-445.
[25] 韩智, 邓安福. 血清降钙素原与社区获得性肺炎严重程度的相关性分析[J]. 现代医药卫生, 2020, 36(1): 98-101.
[26] 李琳, 陈玉清, 陈龙. 降钙素原对老年人急性左心衰竭并发肺部感染的早期诊断意义[J]. 中华老年医学杂志, 2019, 38(8): 836-839.
[27] 陈志海, 周维华. 社区获得性肺炎患者病情严重度与降钙素原水平的相关性分析[J]. 中华肺部疾病杂志(电子版), 2019, 12(3): 337-338.
[28] 郑晓, 郑永华, 胡小燕, 等. 社区获得性肺炎患者血清suPAR、sTREM-1、TNF-α、IL-6变化及临床意义[J]. 临床荟萃, 2021, 36(4): 323-327.
[29] Nagai Y, Yokogawa N, Shimada K, et al. Comparison of the clinical characteristics and severity of community-acquired pneumonia between patients with rheumatoid arthritis treated with tocilizumab and those treated with TNF inhibitor[J]. Mod Rheumatol, 2019, 29(5): 782-787.
[30] 刘洋, 戈艳蕾, 孙晔, 等. NLR、PLR对社区获得性肺炎严重程度的预测价值[J]. 华北理工大学学报(医学版), 2021, 23(6): 438-443.
[31] 刘晋, 张彩苹. 诱导痰细胞学分类与NLR、PLR在哮喘病情评估中的作用[J]. 国际呼吸杂志, 2019,(11): 814-819.
[32] 钟明媚, 丁震, 李秀, 等. 血清血管生成素-2与老年人社区获得性肺炎严重程度的相关性研究[J]. 中华老年医学杂志, 2022, 41(1): 26-29.
