Changes in sVCAM-1,ET-1 and IL-6 levels during anti-infective therapy and their impact on prognosis of elderly pneumonia patients

Li Xinpeng; Feng Yulong; Ding Ruru

doi:10.3969/j.issn.1672-8521.2025.03.007

Abstract：Objective:To investigate the dynamics of serum soluble vascular cell adhesion molecule-1(sVCAM-1),endothelin-1(ET-1)and interleukin-6(IL-6)during anti-infective therapy in elderly pneumonia patients and their prognostic value.Methods:Ninety-one elderly pneumonia patients received anti-infective treatment in Henan Provincial Workers'Hospital from January 2021 to January 2024 were enrolled.Serum sVCAM-1,ET-1 and IL-6 levels were measured before treatment and at day 10 of therapy.At 7 days of treatment,patients were assessed according to the modified Clinical Pulmonary Infection Score(CPIS)and stratified into good prognosis and poor prognosis groups.The good prognosis group was defined as showing complete improvement or significant clinical amelioration,while the poor prognosis group included cases with disease progression or mortality.General data and serum sVCAM-1,ET-1 and IL-6 levels were compared between the two groups.Logistic regression identified independent risk factors.Results:After treatment,serum sVCAM-1 levels decreased from 2,402.95±159.73 pg/mL to 2,146.79±64.67 pg/mL(t=14.180,P＜0.001);ET-1 levels decreased from 2.95±0.52 pg/mL to 1.14±0.47 pg/mL(t=24.633,P＜0.001);IL-6 levels decreased from 18.42±9.04 pg/mL to 8.74±3.21 pg/mL(t=9.625,P＜0.001).There was no statistically significant difference in the comparison of general information between the two groups,such as age,gender,history of diabetes mellitus,and history of hypertension(P＞0.05).The proportion of critically ill patients in the good prognosis group was significantly lower than that in the poor prognosis group(33.33%vs.55.00%,χ2=4.297,P=0.038).Compared with the poor prognosis group,the sVCAM-1 in the good prognosis group[(2,121.41±62.15)pg/mL vs.(2,179.12±66.36)pg/mL,t=4.267,P＜0.001],ET-1[(1.16±0.69)pg/mL vs.(2.24±0.81)pg/mL,t=6.864,P＜0.001]and IL-6[(7.73±3.34)pg/mL vs.(10.02±3.51)pg/mL,t=3.174,P＜0.001]decreased significantly.Logistic regression analysis showed that severe pneumonia(OR=5.786,95%CI 1.049-31.919,P=0.044),elevated sVCAM-1(OR=4.869,95%CI 1.608-14.737,P＜0.001),ET-1 elevation(OR=5.333,95%CI 1.610-17.664,P＜0.001)and elevated IL-6(OR=5.053,95%CI 1.571-16.251,P＜0.001)were independent risk factors affecting the prognosis of elderly patients with pneumonia.The area under the receiver operating characteristic curve of this prediction model was 0.890,with a sensitivity and specificity of 92.98%and 89.18%,respectively.Conclusions:In the anti-infective treatment of pneumonia in the elderly,there are complex connections among sVCAM-1,ET-1 and IL-6,and their high serum expression suggest a poor prognosis.