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Received:July 01, 2025 Published Online:May 22, 2026
Received:July 01, 2025 Published Online:May 22, 2026
中文摘要: 目的 探讨可溶性肿瘤坏死因子样凋亡弱诱导剂（sTWEAK）、叉头框蛋白M1（FOXM1）在重症肺炎（SP）伴呼吸衰竭（RF）患者血清中的水平及与预后的关系。方法 将河北省胸科医院2024年2月至2025年2月收治的193例SP伴RF患者及185例单纯SP患者分别设为SP伴RF组和SP组，并根据28 d预后将SP伴RF患者分为存活组（n=151）和死亡组（n=42）。血清 sTWEAK、FOXM1 水平采用酶联免疫吸附法检测。相关性分析采用Pearson相关系数；SP伴RF患者预后的影响因素采用多因素Cox回归分析；血清sTWEAK、FOXM1对SP伴RF患者预后的预测价值采用受试者工作特征（ROC）曲线分析。结果 与 SP 组比较，SP 伴 RF 组血清 sTWEAK、FOXM1水平均显著升高（t=14.888、18.028，P＜0.05）。相比存活组，死亡组急性生理学和慢性健康状况评分系统Ⅱ（APACHE Ⅱ）评分、白细胞计数（WBC）及血清 sTWEAK、FOXM1 水平更高（t=11.900、6.431、7.160、7.534，P＜0.05）。Pearson相关性分析显示，SP伴RF患者血清sTWEAK、FOXM1水平与APACHE Ⅱ评分和WBC呈正相关（P＜0.05）；APACHEⅡ评分（HR=1.839）、WBC（HR=1.465）及血清 sTWEAK（HR=1.618）、FOXM1（HR=1.657）水平均为患者预后的影响因素（P＜0.05）。血清 sTWEAK、FOXM1 联合预测 SP 伴 RF 患者 28 d 内死亡的敏感度为90.48%，特异度为81.46%，曲线下面积（AUC）为0.886。结论 SP 伴RF 患者血清sTWEAK、FOXM1水平较高，且血清sTWEAK联合FOXM1预测SP伴RF患者预后的效能较高，可为临床诊治提供一定参考。
Abstract:Objective To explore the levels of soluble tumor necrosis factor-like weak inducer of apoptosis（sTWEAK）and forkhead box protein M1（FOXM1）in the serum of patients with severe pneumonia（SP）complicated with respiratory failure（RF）and their relationship with prognosis. Methods From February 2024 to February 2025，193 SP patients complicated with RF and 185 patients with simple SP in Hebei Chest Hospital were enrolled as SP complicated with RF group and SP group，respectively. According to the 28-day prognosis，SP complicated with RF patients were classified into survival group（n=151）and death group（n=42）. Serum sTWEAK and FOXM1 were measured by enzyme-linked immunosorbent assay. Pearson correlation coefficient was used for correlation analysis. The factors influencing the prognosis of SP patients complicated with RF were analyzed using multivariate Cox regression. The predictive value of serum sTWEAK and FOXM1 for the prognosis of these patients was analyzed using receiver operating characteristic（ROC）curves. Results The SP complicated with RF group had significantly higher serum sTWEAK and FOXM1 compared to SP group（t=14.888，18.028，P＜0.05）. Compared with the survival group，the Acute Physiology and Chronic Health Evaluation Ⅱ（APACHEⅡ）score，white blood cell count（WBC），and the serum levels of sTWEAK and FOXM1 in the death group were significantly higher（t=11.900，6.431，7.160，7.534，P＜0.05）. Pearson correlation analysis showed that the serum sTWEAK and FOXM1 levels were positively correlated with the APACHE Ⅱ score and WBC count in SP patients complicated with RF（P＜0.05）；the APACHE Ⅱ score，WBC，serum levels of sTWEAK and FOXM1 were all prognostic factors for these patients（HR=1.839，1.465，1.618，1.657，P＜0.05）. The sensitivity and specificity of the combination of serum sTWEAK and FOXM1 for predicting 28 - day mortality in SP patients complicated with RF were 90.48% and 81.46% ，respectively，and the area under the curve（AUC）was 0.886.Conclusion The serum levels of sTWEAK and FOXM1 in SP patients complicated with RF are relatively high.Moreover，the combination of serum sTWEAK and FOXM1 has higher predictive efficacy for their prognosis，which canprovide certain reference for clinical diagnosis and treatment.
keywords: Severe pneumonia Respiratory failure Prognosis Soluble tumor necrosis factor - like weak inducer of apoptosis Forkhead box protein M1 White blood cell count
文章编号： 中图分类号：R563.1 R563.8 文献标志码：A
基金项目:河北省卫生健康委医学科学研究课题（20250843）
| Author Name | Affiliation |
| ZHANG Luoyuan，GAO Yong，QI Tianhang，LI Yang | Fifth Department of Respiratory Medicine,Hebei Chest Hospital,Shijiazhuang,Hebei 050047,China |
| Author Name | Affiliation |
| ZHANG Luoyuan，GAO Yong，QI Tianhang，LI Yang | Fifth Department of Respiratory Medicine,Hebei Chest Hospital,Shijiazhuang,Hebei 050047,China |
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