Analysis of the changes and diagnostic value of serum sCD163,CRP and PCT in patients with stroke-associated pneumonia

GU Honghong; JIAO Jianhua

doi:10.3969/j.issn.1002-3429.2025.23.014

Abstract：Objective To investigate the clinical value of combined detection of serum scavenger receptor cysteine-rich type 1 protein M130(sCD163),C reactive protein(CRP),and procalcitonin(PCT)in the diagnosis of stroke-associated pneumonia(SAP).Methods A total of 108 acute ischemic stroke(AIS)patients with suspected SAP from March 2023 to October 2024 were randomly included as the research subjects.According to SAP diagnostic criteria,they were divided into SAP group(n=75)and non-SAP group(n=33).The SAP group was divided into mild subgroup(n=47,classesⅠ～Ⅲ)and severe subgroup(n=28,classes Ⅳ～Ⅴ)based on pneumonia severity index(PSI).In addition,30 patients with bacterial pneumonia admitted during the same period were selected as simple pulmonary infection group and 30 healthy volunteers as the healthy control group.Enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of serum sCD163,CRP,and PCT in each group at admission or during physical examination.The clinical data,the above parameters,and their correlation with disease severity were observed and compared among groups.Risk factors for SAP were analyzed,and the diagnostic value of each indicator for SAP was evaluated.Results Compared with the non-SAP group,patients in the SAP group exhibited increased age,higher National Institutes of Health Stroke Scale(NIHSS)scores,prolonged bedridden time,and a greater proportion of primary pulmonary disease,showing significant differences(P<0.05,P<0.01).The serum CRP and PCT levels were significantly higher in simple pulmonary infection group,as compared with the healthy control group;only CRP level was higher in non-SAP group,while sCD163,CRP,and PCT levels were all significantly higher in SAP group(P<0.05).The levels of sCD163,CRP,and PCT in severe subgroup were significantly higher than those in mild subgroup(P<0.01).Spearman correlation analysis showed a positive correlation between sCD163 level and NIHSS and PSI scores(P<0.01).Multivariate Logistic regression showed that age,NIHSS score,sCD163,and PCT levels were independent risk factors for the occurrence of SAP(P<0.01).Receiver operating characteristic(ROC)curve showed that area under ROC curve(AUC)of sCD163 and PCT levels for predicting SAP occurrence was 0.776 and 0.702,respectively.The AUC of combined diagnosis was 0.856,significantly higher than that by single indicator.Conclusion Elevated levels of serum sCD163,CRP,and PCT are closely related to the occurrence of SAP,especially sCD163,which can serve as important biomarker for early diagnosis of SAP.Therefore,combined detection of sCD163 and PCT can further enhance the diagnostic performance.