Evaluation of a combined peripheral blood Th1/Th2 cytokine and pneumonia severity index model for prognosis in patients with severe pneumonia
SHEN Ling-jun
GUO Si-lang
SHAO Wei
CHANG Yin-jiang
Abstract：Objective To investigate the prognostic value of a combined model based on peripheral blood helper T lymphocyte 1/helper T lymphocyte 2(Th1/Th2)cytokines and pneumonia severity index(PSI)scores in patients with severe pneumonia.Methods A total of 120 patients with severe pneumonia admitted from January 2021 to August 2023 were included and followed up for 1 year.According to survival during follow-up,patients were divided into a survival group(n=82)and a non-survival group(n=38).Demographic data,laboratory parameters,and PSI scores were com-pared between groups.Multivariate logistic regression analysis was performed to identify independent risk factors for mor-tality.A logistic regression prediction model was constructed,and receiver operating characteristic(ROC)curves were used to assess the predictive performance,with area under the curve(AUC)calculated.Results Compared with the sur-vival group,the non-survival group had significantly higher mean age[(80.62±10.41)years vs.(70.18±18.30)years],neutrophil-to-lymphocyte ratio(NLR)(13.60±2.45 vs.10.79±6.12),and PSI score(127.64±22.18 vs.113.59±20.61)(t=3.275,2.726,3.299;P＜0.05).Hospital stay[(11.15±10.03)days vs.(18.45±11.26)days]and peripheral blood Th1/Th2 cytokine ratio(4.02±1.02 vs.5.01±1.62)were lower in the non-surviv-al group(t=3.146,3.458;P＜0.05).Multivariate logistic regression identified age(OR=1.613,95％CI:1.744-3.498),hospital stay(OR=1.603,95％CI:1.729-3.525),NLR(OR=1.793,95％CI:1.837-3.844),Th1/Th2 ratio(OR=1.840,95％CI:1.806-4.200),and PSI score(OR=1.817,95％CI:1.818-4.034)as independ-ent risk factors for mortality.The logistic regression prediction model was constructed as follows:logistic(P)=-4.516+0.610×(Th1/Th2)+0.597×(PSI score).The model showed a sensitivity of 79.85％,specificity of 90.65％,and AUC of 0.912 for predicting mortality.Conclusion The combined model of peripheral blood Th1/Th2 cytokine ratio and PSI score demonstrates high sensitivity,specificity,and AUC in predicting mortality in patients with severe pneumonia,providing valuable guidance for clinical prognosis assessment.
Keywords：severe pneumoniahelper T lymphocyte 1/Helper T lymphocyte 2pneumonia severity indexprog-nostic modeloutcome
Publication Date：2025-10-15
Online Publishing Date：2025-11-28(First online date of this platform, not the publication date of the document)
Pages：5( 1586-1590 )