目的 探讨可溶性CD163（sCD163）、应激性血糖升高比值（SHR）、肾上腺髓质素前体（pro-ADM）、正五聚蛋白3（PTX3）联合胸部计算机断层扫描（CT）评分对老年卒中相关性肺炎患者病情、预后的评估价值。 方法 选取2023年3月至2025年3月张家口市第一医院收治的112例老年卒中相关性肺炎患者作为研究对象，治疗3个月后根据预后情况分为预后良好组（77例）和预后不良组（35例），根据患者病情严重程度分为轻度组（36例）、中度组（45例）、重度组（31例）。比较各组血清sCD163、SHR、pro-ADM、PTX3水平及胸部CT评分，采用Pearson分析相关性，并将预后不良组定义为阳性，预后良好组定义为阴性，绘制受试者工作特征曲线（ROC）分析预测价值，获取曲线下面积（AUC）。 结果 重度组血清sCD163、SHR、pro-ADM、PTX3水平及胸部CT评分均高于中度组、轻度组，中度组高于轻度组（P < 0.05）。预后不良组与预后良好组进行组间比较，血清sCD163、SHR、pro-ADM、PTX3水平及胸部CT评分均更高（P < 0.05）。Pearson相关性分析结果显示，血清sCD163、SHR、pro-ADM、PTX3水平与胸部CT评分均呈正相关（r = 0.775、0.615、0.825、0.866，P < 0.05）；血清sCD163、SHR、pro-ADM、PTX3水平、胸部CT评分与NIHSS评分均呈正相关（r = 0.682、0.793、0.847、0.805、0.762，P < 0.05）。ROC分析结果显示，血清sCD163、SHR、pro-ADM、PTX3水平联合胸部CT评分联合检测预测老年卒中相关性肺炎患者预后的AUC值为0.903，高于各指标单独检测（0.803、0.758、0.786、0.787、0.752，P < 0.05）。 结论 血清sCD163、SHR、pro-ADM、PTX3水平及胸部CT评分与老年卒中相关性肺炎患者病情和预后有关，且五者联合检测对老年卒中相关性肺炎患者预后的预测价值更高。

Objective To explore the evaluation value of soluble CD163 （sCD163）， stress hyperglycemia ratio （SHR）， adrenomedullin precursor （pro-ADM）， and pentraxin 3 （PTX3） in combination with the score of chest computed tomography （CT） in elderly patients with stroke-related pneumonia. Methods A total of 112 elderly patients with stroke-related pneumonia who were admitted to our hospital between March 2023 and March 2025 were selected as the research subjects. After 3 months of treatment， they were divided into the good prognosis group （77 cases） and the poor prognosis group （35 cases）. Additionally， they were classified into the mild group （36 cases）， the moderate group （45 cases）， and the severe group （31 cases） according to the severity of the patients' illness. The serum levels of sCD163， SHR， pro-ADM， and PTX3， as well as chest CT scores， were compared among the groups. Pearson correlation analysis was used to assess the relationships. The poor prognosis group was defined as positive and the favorable prognosis group as negative. Then， the receiver operating characteristic （ROC） curve was plotted to evaluate the predictive value， and the area under the curve （AUC） was obtained. Results The levels of serum sCD163， SHR， pro-ADM， PTX3， and the chest CT score in the severe group were higher than those in the moderate and mild groups， and the levels in the moderate group were higher than those in the mild group （P < 0.05）. Inter-group comparisons between the poor prognosis group and the good prognosis group revealed that the levels of serum sCD163， SHR， pro-ADM， PTX3， and the chest CT score were higher in the poor prognosis group （P < 0.05）. Pearson correlation analysis showed that the levels of serum sCD163， SHR， pro-ADM， and PTX3 were positively correlated with the chest CT score （r = 0.775， 0.615， 0.825， 0.866， P < 0.05）. The levels of serum sCD163， SHR， pro-ADM， PTX3， the chest CT score， and the NIHSS score were positively correlated （r = 0.682， 0.793， 0.847， 0.805， 0.762， P < 0.05）. The ROC analysis showed that the AUC value of the combined detection of the levels of serum sCD163， SHR， pro-ADM， and PTX3 and the chest CT score in predicting the prognosis of elderly patients with stroke-related pneumonia was 0.903， which was higher than that of each individual index （0.803， 0.758， 0.786， 0.787， and 0.752， P < 0.05）. Conclusion Serum levels of sCD163， SHR， pro-ADM， and PTX3， along with chest CT scores， were associated with the condition and prognosis of elderly patients with stroke-related pneumonia. Moreover， the combined detection of these five indicators was more valuable in predicting the prognosis of elderly patients with stroke-related pneumonia.