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目的 探讨病毒性肺炎合并慢阻肺患者预后危险因素及其与血清程序化细胞死亡分子5(Programmed cell death 5, PDCD5)、干扰素γ(Interferon-γ, IFN-γ)的关系。方法 回顾性纳入2022年1月至2025年1月本院329例病毒性肺炎患者(慢阻肺-肺炎组85例，单纯肺炎组244例)及150例健康对照。结果 慢阻肺-肺炎组血清PDCD5、IFN-γ水平显著高于单纯肺炎组及健康对照组(P<0.05);Logistic多因素分析显示：慢阻肺既往频繁急性加重≥2次/年、GOLD Ⅲ～Ⅳ级、需机械通气、NLR、PDCD5、IFN-γ是预后不良独立危险因素(P<0.05),FEV1/FVC是保护因素(P<0.05);ROC曲线证实上述因素对预后不良均有预测价值(P<0.05)；决策树模型(以NLR为首要分层指标)分类准确率达98.0%;Pearson相关性显示：PDCD5、IFN-γ与既往频繁急性加重次数、GOLD分级、NLR呈正相关(P<0.05)，与FEV1/FVC呈负相关(P<0.05)。结论 监测危险因素可早期识别高风险患者，指导精准干预以改善预后。
Abstract：Objective To investigate the prognostic risk factors in patients with viral pneumonia complicated by chronic obstructive pulmonary disease(COPD) and to explore their associations with serum programmed cell death 5(PDCD5) and interferon-γ(IFN-γ).Methods A total of 329 patients with viral pneumonia(85 in the COPD-pneumonia group and 244 in the simple pneumonia group) and 150 healthy controls admitted to our hospital between January 2022 and January 2025 were retrospectively analyzed. Serum PDCD5 and IFN-γ levels in the COPD-pneumonia group were significantly higher than those in the simple pneumonia and healthy control groups(P<0.05). Results Multivariate logistic regression analysis identified frequent acute exacerbations of COPD (≥2 times/year), GOLD stage Ⅲ-Ⅳ, requirement for mechanical ventilation, neutrophil-to-lymphocyte ratio(NLR), PDCD5, and IFN-γ as independent risk factors for poor prognosis(P<0.05), whereas FEV1/FVC served as a protective factor(P < 0.05). Receiver operating characteristic(ROC) curve analysis confirmed the predictive value of these factors for poor outcomes(P<0.05). A decision tree model using NLR as the primary stratification index achieved a classification accuracy of 98.0%. Pearson correlation analysis revealed that PDCD5 and IFN-γ were positively correlated with the number of previous acute exacerbations, GOLD stage, and NLR(P < 0.05), but negatively correlated with FEV1/FVC(P<0.05). Conclusion These findings suggest that monitoring key prognostic factors can facilitate early identification of high-risk patients and guide precise interventions to improve clinical outcomes.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.250246
中图分类号:R563.9;R563.1
引用信息:
[1]芦丹,黄莺,张薇,等.合并慢阻肺的病毒性肺炎患者预后相关危险因素及其与血清PDCD5,IFN-γ的关系[J].病毒学报,2026,42(03):783-792.DOI:10.13242/j.cnki.bingduxuebao.250246.
基金信息:
湖北省中医药管理局中医药科研项目(项目号:ZY2025L021),题目:纳米姜黄素通过Nrf2介导的抗氧化作用治疗脂多糖诱导的急性肺损伤; 武汉市卫健委科研项目资助(项目号:WX19C04),题目:一种支气管肺泡灌洗导管对COPD患者BALF中GM界值检测的研究~~
2025-08-19
2025
2025-10-16
2025-12-18
2025
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2025-12-19
2025-12-19
2025-12-19