Clinical Diagnostic Efficacy Of Serum SCD14 And HMGB1 Alone Or In Combilation In Pneumonia

[OBJECTIVE]To investigate the value of serum soluble CD 14(sCD 14)and high mobility group box protein B1(HMGB1)in the clinical diagnosis and evaluation of patients with pneumonia.[METHODS]A total of 124 patients with pneumonia were enrolled in the clinical study.According to the severity of clinical diagnosis and the enviroment,the patients were divided into community acquired Non-severe pneumonia group(63 cases)and the community and hospital acquired severe pneumonia group(61 cases).The 58 healthy subjects were used as the control group.Collect 3-5ml of whole blood samples from each group,prepare the samples to be sampled according to the purpose and requirements of the experiment;use ELISA to detect the concentration of sCD14 and HMGB1 in serum;use automatic blood cell analyzer,automatic biochemistry Analyzer,automatic immunochemiluminescence analyzer for detection of white blood cells(WBC),C-reactive protein(CRP),procalcitonin(PCT)and interleukin-6(IL-6),data collection,statistical analysis To assess and compare the clinical diagnostic efficacy of the above indicators in pulmonary infections,were analyzed by using GraphPad Prism 8.0.[RESULTS]The pneumonia patients were divided into the community acquired Non-severe pneumonia group(the Non-severe group)and the community and hospital acquired severe pneumonia group(the severe group)(1)Analysis of the levels of sCD14 and HMGB1 and compared with the levels of PCT and IL-6 in pneumonia.The levels of sCD14 and HMGB1 in the Non-severe pneumonia group were 4.34±0.23ng/ml、535.00±26.63pg/ml;the levels of sCD14 and HMGB1 in the severe pneumonia group were 5.07±0.37ng/ml.744.7±36.06pg/ml,both significantly higher than the control group(P<0.05),consistent with the changes in the reference indicators PCT,IL-6;serum HMGB1 and sCD 14 concentrations in the severe pneumonia group compared with the Non-severe pneumonia group The level was significantly increased(P<0.05),which was also consistent with the changes of the reference indicators PCT and IL-6,suggesting that the expression of sCD14 and HMGB1 has the same trend as PCT and IL-6 when lung infection occurs and develops.Significantly up-regulated and further up-regulated according to the infection process,and the upward trend was significant(P<0.05).(2)Clinical diagnostic efficacy of serum sCD14 and HMGB1 in the diagnosis of pneumoniaThe clinical efficacy of sCD14 and HMGB1 in the diagnosis of pneumonia was analyzed by ROC curve.The results showed that the area under the curve(AUC),sensitivity and specificity of sCD14 and HMGB1 for diagnosis of the Non-severe pneumonia were 0.936,82.50%and 90.60,respectively.%and 0.907,66.70%,98.10%,combined detection of sCD14 and HMGB1 under the premise of little change in specificity(88.88%),can improve AUC to 0.968,sensitivity to 94.17%,approaching PCT,IL-6 combination The diagnostic efficacy of the test:AUC 0.988,sensitivity 99.7%,specificity 85,15%;sCD14,HMGB1 diagnosis of severe pneumonia under the curve area(AUC),sensitivity,specificity were 0.925,82%,86.8%and 0.857,65.6%,92.5%,combined detection of sCD14 and HMGB1 can increase AUC to 0.994 and sensitivity to 93.81%under the premise of little change in specificity(83.28%),and also approach the diagnostic efficacy of combined detection of PCT and IL-6:AUC 0.989,sensitivity 99.77%,specificity 83.28%.(3)The correlation between the diagnostic efficacy of sCD14 and HMGB1 and the PCT and IL-6.The results showed that the sCD14 and HMGB1 were positively correlated with PCT,and the correlation coefficient r was 0.232,0.342(P<0.05).The detection of sCD14 and HMGB1 was positively correlated with IL-6,and the correlation coefficient r was 0.388,0.503(P<0.05).The combined detection of sCD14 and HMGB1 was compared with PCT and IL-6.The combination was significantly correlated,with a correlation coefficient r of 0.832,P<0.05.The above results suggest that HMGB1 and sCD14 can be detected alone or in combination,especially the combined efficacy of the two can meet the needs of clinical diagnosis of pneumonia.[CONCLUSION]The combined detection of serum sCD 14 and HMGB1 has certain clinical value for the auxiliary diagnosis and disease evaluation of pneumonia.It has good clinical application prospects.1.It can be used as the pneumonia and severe disease on the basis of further improvement of methodology.Candidates for diagnosis and assessment of pneumonia;2.sCD14 and HMGB1 are simple and easy to detect,do not require large-scale medical equipment,and can be used as substitute indicators for grassroots medical institutions in rural areas,villages and towns that cannot carry out PCT and IL-6 tests.