The Value Evaluation of Serum sCD74 and LBP for Prognosis of Elderly Cases with Severe Pneumonia Complicated with Respiratory Failure

LIU Qiaoyan; WANG Yongfeng; WANG Ping; XIAO Linping; WANG Juan; XIE Xiaoyan

doi:10.3639/i.issn.2095-3097.2025.01.001

Abstract：Objective To explore the value evaluation of serum soluble CD74(sCD74)and lipopolysaccharide-binding protein(LBP)in elderly cases with severe pneumonia and respiratory failure.Methods A total of 119 elderly cases with severe pneumonia and respiratory failure were selected as the disease group,and 100 healthy subjects admitted for physical examination were selected as the control group.Serum levels of sCD74 and LBP were detected in all participants.According to the 28-day outcome,the 119 cases were divided into survival group(88 cases)and death group(31 cases).The prognostic value of serum sCD74 and LBP was evaluated by ROC curves,and the prognostic factors of elderly cases were explored by multifactor Logistic regression.Results Serum levels of sCD74 and LBP in the disease group were higher than in the control group(P<0.05).Serum levels of sCD74 and LBP in the death group were higher than in the survival group(P<0.05).The AUC(95%CI)of serum sCD74,LBP,and their combined evaluation for the prognosis of elderly cases were 0.741(0.696-0.786),0.829(0.784-0.874),and 0.922(0.877-0.972),respectively.The percentages of leukocyte count,interleukin-6,interleukin-10,tumor necrosis factor level,APACHE Ⅱ score≥20,and mechanical ventilation time<10 days in the death group were higher than those in the survival group(P<0.05).Multivariate analysis showed that APACHE Ⅱ score≥20 points(OR=2.578,95%CI:1.219-5.451),serum sCD74≥76.79 ng/mL(OR=3.200,95%CI:1.798-5.693),and serum LBP≥123.63 ng/mL(OR=4.129,95%CI:1.867-9.132)were prognostic risk factors for elderly cases(P<0.05).Conclusion High sCD74 and LBP levels are closely related to the prognosis of elderly cases with severe pneumonia and respiratory failure.The combined monitoring of sCD74 and LBP levels has important clinical significance for the condition,treatment,and prognosis of patients.