目的 研究英国胸科协会改良肺炎评分（CURB-65）及血清白细胞介素-6（IL-6）、降钙素原/白蛋白（PCT/ALB）水平与重症肺炎患者预后的关系。 方法 回顾性分析2022年6月至2025年7月黄山市人民医院呼吸与危重症医学科接诊的110例重症肺炎患者（重症组）临床资料，另选择同期就诊的轻症肺炎病例55例（轻症组），收集两组患者一般临床资料、入院时CURB-65评分、血清IL-6、PCT/ALB比值等资料，Pearson法分析CURB-65评分与血清IL-6、PCT/ALB的相关性，对重症肺炎依据CURB-65评分分为低危（n = 34）、中危（n = 53）、高危（n = 23），依据其治疗后28 d预后情况分为预后良好组（n = 80）和预后不良组（n = 30），对比不同病情、不同预后的重症肺炎患者CURB-65评分、血清IL-6、PCT/ALB，二元logistic回归分析重症肺炎患者预后影响因素，绘制ROC评估CURB-65评分、IL-6、PCT/ALB对重症肺炎预后的评估价值。 结果 重症组入院时CURB-65评分、血清IL-6、PCT及PCT/ALB高于轻症组，而ALB低于轻症组（P < 0.05）；Pearson相关分析显示，重症肺炎患者血清IL-6、PCT及PCT/ALB与CURB-65评分呈正相关，ALB与CURB-65评分呈负相关（P < 0.05）；CURB-65评分为高危患者血清IL-6、PCT/ALB高于低危、中危患者，低危、中危患者IL-6、PCT/ALB差异也有统计学意义（P < 0.05）；预后不良组入院时CURB-65评分、IL-6、PCT/ALB高于预后良好组，而ALB低于预后良好组（P < 0.05）；二元logistic回归分析显示，CURB-65评分、血清IL-6、PCT/ALB是重症肺炎预后独立危险性因素（P < 0.05）；ROC曲线显示，CURB-65评分、血清IL-6、PCT/ALB联合预测重症肺炎死亡的曲线下面积为0.944（0.878 ~ 0.980），高于各指标单独预测（Z = 2.162、6.931、2.168，P < 0.05），且联合时敏感度、特异度分别为92.59%、95.77%，CURB-65评分、血清IL-6、PCT/ALB的截断值分别为4分、26.45 pg/mL、0.79。 结论 CURB-65评分、血清IL-6及PCT/ALB比值升高可用于预测重症肺炎病情，且三者均与患者预后不良有关，CURB-65评分、血清IL-6及PCT/ALB联合对重症肺炎预后有一定预测价值，可结合以上指标筛查高危患者，及时采取干预措施，改善患者预后。

Objective To investigate the relationship between the CURB-65 score， serum interleukin-6 （IL-6） level， procalcitonin/albumin （PCT/ALB） ratio and the prognosis of patients with severe pneumonia. Methods A retrospective analysis was conducted on the clinical data of 110 patients with severe pneumonia （severe group） admitted to the Department of Respiratory and Critical Care Medicine， Huangshan City People's Hospital between June 2022 and July 2025. Simultaneously， 55 patients with mild pneumonia （mild group） were recruited. General clinical data， CURB-65 scores upon admission， serum IL-6 levels， and PCT/ALB ratio were gathered. Pearson′s method was employed to analyze the correlation between the CURB-65 score and serum IL-6 as well as the PCT/ALB ratio. Patients with severe pneumonia were classified into the low-risk group （n = 34）， intermediate-risk group （n = 53）， and high-risk group （n = 23） according to the CURB-65 score. Based on the 28-day prognosis， they were categorized into the favorable prognosis group （n = 80） and unfavorable prognosis group （n = 30）. The CURB-65 scores， serum IL-6 levels， and PCT/ALB ratios were compared among patients with different severities and prognoses. Binary logistic regression analysis was employed to identify prognostic factors， and receiver operating characteristic （ROC） curves were plotted to assess the prognostic value of the CURB-65 score， IL-6， and PCT/ALB ratio. Results Upon admission， patients in the severe group exhibited higher CURB-65 scores， serum IL-6 levels， PCT levels， and PCT/ALB ratios， but lower ALB levels compared to those in the mild group （P < 0.05）. Pearson correlation analysis indicated that in patients with severe pneumonia， serum IL-6， PCT， and PCT/ALB ratios were positively correlated with the CURB-65 score， whereas ALB was negatively correlated with the CURB-65 score （P < 0.05）. High-risk patients had higher serum IL-6 levels and PCT/ALB ratios than both low-risk and intermediate-risk patients. Moreover， significant differences were also observed between low-risk and intermediate-risk patients （P < 0.05）. At admission， the unfavourable prognosis group had higher CURB-65 scores， serum IL-6 levels， and PCT/ALB ratios but lower ALB levels than the favourable prognosis group （P < 0.05）. Binary logistic regression analysis revealed that the CURB-65 score， serum IL-6 level， and PCT/ALB ratio were independent risk factors for the prognosis of patients with severe pneumonia （P < 0.05）. ROC curve analysis indicated that the area under the curve （AUC） of the combination of the CURB-65 score， serum IL-6 level， and PCT/ALB ratio for predicting death in severe pneumonia was 0.944 （95%CI： 0.878 - 0.980）， which was greater than that of each individual indicator （Z = 2.162， 6.931， 2.168； P < 0.05）. The sensitivity and specificity of the joint prediction were 92.59% and 95.77%， respectively. The cut-off values of the CURB-65 score， serum IL-6 level， and PCT/ALB ratio were 4， 26.45 pg/mL， and 0.79， respectively. Conclusions An elevated CURB-65 score， serum IL-6 level， and PCT/ALB ratio are all associated with the severity and poor prognosis of severe pneumonia. The combination of these three indicators holds predictive value for the prognosis and can be employed to screen high-risk patients， thus facilitating timely intervention and enhancing the prognosis.