sCD163、SHR、pro-ADM、PTX3联合胸部CT评分对老年卒中相关性肺炎患者病情、预后的评估价值

doi:10.3969/j.issn.1006-5725.2026.03.012

Abstract

Abstract:

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.

Key words: stroke associated pneumonia, old age, soluble CD163, stress blood sugar elevation ratio, adrenomedullin precursor, pentraxin 3, pulmonary computed tomography score, prognosis

CLC Number:

R563.1

Jianhua JIAO,Ruixue MA,Honghong GU,Xing WU,Xiuli CAO. Evaluation value of sCD163， SHR， pro-ADM， PTX3 combined with score of chest CT on the condition and prognosis of elderly patients with stroke-related pneumonia[J]. The Journal of Practical Medicine, 2026, 42(3): 447-454.

Figures/Tables 8

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Fig.1

Fig.2

Fig.3

References 32

[1]	ZHONG A. On the Pathophysiology of Stroke‐Associated Pneumonia： A Brief Review［J］. Neuro Clin Neuro， 2025， 13（5）： 327-334. doi： 10.1111/NCN3.70030 . doi: 10.1111/NCN3.70030
[2]	杨晓华，陈惠娟，何娟，等. 急性缺血性脑卒中患者口腔清洁度异常与卒中相关性肺炎的影响因素及关系［J］. 实用医学杂志， 2022， 38（17）： 2170-2174， 2180. doi： 10.3969/j.issn.1006-5725.2022.17.010 . doi: 10.3969/j.issn.1006-5725.2022.17.010
[3]	WANG Y， WANG T， HU S， et al. Procalcitonin and biomarkers for stroke-associated pneumonia： A systematic review and meta-analysis［J］. BMC Pulm Med， 2025， 25（1）： 286-286. doi： 10.1186/S12890-025-03750-6 . doi: 10.1186/S12890-025-03750-6
[4]	LIN K， DENG X， XIAO Y， et al. Risk factors of stroke-associated pneumonia in patients with acute ischemic stroke treated by endovascular thrombectomy［J］. BMC Neuro， 2025， 25（1）： 165-165. doi： 10.1186/S12883-025-04182-9 . doi: 10.1186/S12883-025-04182-9
[5]	TAKEDA S， NAMISAKI T， KOIZUMI A， et al. The Macrophage Activation Marker Soluble CD163 Predicts the Response to Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma［J］. Anticancer Res， 2025， 45（10）： 4493-4507. doi： 10.21873/ANTICANRES.17797 . doi: 10.21873/ANTICANRES.17797
[6]	JIN X， DENG W， WENG Q， et al. Correlation between stress hyperglycemia ratio and risk of acute respiratory distress syndrome in patients with sepsis： A MIMIC-IV cohort study［J］. Sci Rep， 2025， 15（1）： 34737-34737. doi： 10.1038/S41598-025-18349-4 . doi: 10.1038/S41598-025-18349-4
[7]	LI Y， HUANG F， CHEN D， et al. Deep Learning Models for CT Segmentation of Invasive Pulmonary Aspergillosis， Mucormycosis， Bacterial Pneumonia and Tuberculosis： A Multicentre Study［J］. Mycoses， 2025， 68（7）： e70084-e70084. doi： 10.1111/MYC.70084 . doi: 10.1111/MYC.70084
[8]	代锟，张莉莉，夏语，等. 基于“头气街”理论针刺联合血管内介入治疗缺血性脑卒中：随机对照试验［J］. 中国针灸， 2025， 45（6）： 723-727. doi： 10.13703/j.0255-2930.20241107-k0003 . doi: 10.13703/j.0255-2930.20241107-k0003
[9]	FLORENCIA G， MARIA A G， GUILLERMO J K. Usefulness of NIHSS score as a predictor of non-neurological in-hospital complications in stroke［J］. Med Clin （Barc）， 2021， 157（9）： 434-437. doi： 10.1016/J.MEDCLE.2020.07.045 . doi: 10.1016/J.MEDCLE.2020.07.045
[10]	中国卒中学会急救医学分会，中华医学会急诊医学分会卒中学组，中国老年医学学会急诊医学分会，等. 卒中相关性肺类诊治中国专家共识（2019更新版）［J］. 中国急救医学， 2019， 39（12）： 1135-1143. doi： 10.7666/d.Y2180877 . doi: 10.7666/d.Y2180877
[11]	杨晓华，陈惠娟，何娟，等. 急性缺血性脑卒中患者口腔清洁度异常与卒中相关性肺炎的影响因素及关系［J］. 实用医学杂志， 2022， 38（17）： 2170-2174+2180. doi： 10.3969/j.issn.1006-5725.2022.17.010 . doi: 10.3969/j.issn.1006-5725.2022.17.010
[12]	ZHANG Q， LIU H， SUN J， et al. Reducing stroke-associated pneumonia through pulmonary rehabilitation in moderate-to-severe acute ischemic stroke［J］. Eur J Med Res， 2025， 30（1）： 208-208. doi： 10.1186/S40001-025-02451-4 . doi: 10.1186/S40001-025-02451-4
[13]	YANG X， LU Y， CHEN H， et al. Oral hygiene is independently associated with early stroke-associated pneumonia in hospitalized patients with ischemic stroke： An observational study［J］. Medicine， 2025， 104（10）： e41758-e41758. doi： 10.1097/MD. 0000000000041758 . doi: 10.1097/MD. 0000000000041758
[14]	CAILING X， JIANYU W， JUAN J， et al. Evaluation of a Specialized Nurse Decision Support System in the Prevention of Stroke-Associated Pneumonia［J］. J Clin Nurs， 2025， 8（12）： 363-368. doi： 10.26689/JCNR.V8I12.9052 . doi: 10.26689/JCNR.V8I12.9052
[15]	MOHAPATRA S， PATHI K B， MOHAPATRA I， et al. Bacteriological Profile of Patients With Stroke-Associated Pneumonia and Antimicrobial Susceptibility of Pathogens： A Cross-Sectional Study［J］. Cureus， 2024， 16（11）： e74150-e74150. doi： 10.7759/CUREUS.74150 . doi: 10.7759/CUREUS.74150
[16]	ZHENG F， GAO W， XIAO Y， et al. Systemic inflammatory response index as a predictor of stroke-associated pneumonia in patients with acute ischemic stroke treated by thrombectomy： A retrospective study［J］. BMC Neuro， 2024， 24（1）： 287-287. doi： 10.1186/S12883-024-03783-0 . doi: 10.1186/S12883-024-03783-0
[17]	陆伟，柯荣湖，蔡俊. 大螺距低剂量肺部CT技术在COPD患者中的应用价值［J］. 影像科学与光化学， 2020， 38（3）： 503-507. doi： 10.7517/issn.1674-0475.191118 . doi: 10.7517/issn.1674-0475.191118
[18]	梁拥辉，杨中杰，师新宇，等. 肺炎支原体抗体滴度与肺炎支原体肺部感染成年患者CT影像特点的相关性分析［J］. 中华医院感染学杂志， 2020， 30（9）： 1340-1344. doi： 10.11816/cn.ni.2020-190428 . doi: 10.11816/cn.ni.2020-190428
[19]	杨浩然，张学勤. 细菌感染性肺炎患者胸部CT征象及其与患者肺部炎症情况、预后的关系［J］. 影像科学与光化学， 2021， 39（5）： 705-710. doi： 10.7517/issn.1674-0475.210212 . doi: 10.7517/issn.1674-0475.210212
[20]	SHAO L， LIANG Y. Predictive value of bedside lung ultrasound， quantitative chest CT， and frailty assessment for short-term outcomes in elderly patients with severe pneumonia： A pilot study［J］. BMC Pulm Med， 2025， 25（1）： 474-474. doi： 10.1186/S12890-025-03950-0 . doi: 10.1186/S12890-025-03950-0
[21]	PARK S， CHOE J， KIM C H， et al. Evaluation of Autoimmune Features in Patients with Idiopathic Pulmonary Fibrosis and Pathologic Usual Interstitial Pneumonia： Implications for CT Patterns and Prognosis［J］. Radiology， 2025， 314（3）： e242292-e242292. doi： 10.1148/RADIOL.242292 . doi: 10.1148/RADIOL.242292
[22]	SHA L， LI W， NA C， et al. Differential clinical and CT imaging features of pneumonic-type primary pulmonary lymphoma and pneumonia： A retrospective multicentre observational study［J］. BMJ open， 2023， 13（10）： e077198-e077198. doi： 10.1136/BMJOPEN-2023-077198 . doi: 10.1136/BMJOPEN-2023-077198
[23]	MIWA K， KEN N， MAYUKO K， et al. Soluble CD163 is a predictor of fibrosis and hepatocellular carcinoma development in nonalcoholic steatohepatitis［J］. BMC gastroenterol， 2023， 23（1）： 143-143. doi： 10.1186/S12876-023-02786-4 . doi: 10.1186/S12876-023-02786-4
[24]	GKIOKAS A， GIGANTE P M， GKIOKA I A， et al. Tumor-Associated Macrophage （TAM）-Related Cytokines， sCD163， CCL2， and CCL4， as Novel Biomarkers for Overall Survival and Time to Treatment in Waldenstrom′s Macroglobulinemia： Emphasis on Asymptomatic WM［J］. Cells， 2025， 14（4）： 275-275. doi： 10.3390/CELLS14040275 . doi: 10.3390/CELLS14040275
[25]	PLEVRITI A， LAMPROU M， MOURKOGIANNI E， et al. The Role of Soluble CD163 （sCD163） in Human Physiology and Pathophysiology［J］. Cells， 2024， 13（20）： 1679-1679. doi： 10.3390/CELLS13201679 . doi: 10.3390/CELLS13201679
[26]	AKASAKA H， TABARA Y， FUKUMA K， et al. Association between plasma mid-regional pro-adrenomedullin levels and muscle properties［J］. Geriatr Gerontol Int， 2025， 25（10）： 1418-1424. doi： 10.1111/GGI.70155 . doi: 10.1111/GGI.70155
[27]	ARIAS Z T， MEDA A M， RIVERO A I， et al. N-Acetylcysteine and pro-adrenomedullin dual-crosslinked gelatin-chitosan hydrogels with enhanced mechanical and mineralization performance［J］. RSC Adv， 2025， 15（28）： 22524-22533. doi： 10.1039/D5RA03349G . doi: 10.1039/D5RA03349G
[28]	GQ S， L Y， LY S， et al. Investigation of the clinical significance of detecting PTX3 for community-acquired pneumonia［J］. Eur Rev Med Pharmacol Sci， 2020， 24（16）： 8477-8482. doi： 10.26355/EURREV_202008_22645 . doi: 10.26355/EURREV_202008_22645
[29]	LI J， LV J， WONG G M， et al. Correlation of Urinary Soluble CD163 Levels With Disease Activity and Treatment Response in IgA Nephropathy［J］. Kidney Int Rep， 2024， 9（10）： 3016-3026. doi： 10.1016/J.EKIR.2024.07.031 . doi: 10.1016/J.EKIR.2024.07.031
[30]	XU J， ZHOU H， WANG Z. Accelerated biological aging mediates the associations of stress hyperglycemia ratio （SHR） with mortality in type 2 diabetes and obesity （diabesity）［J］. Cardiovasc Diabetol， 2025， 24（1）： 368-368. doi： 10.1186/S12933-025-02931-1 . doi: 10.1186/S12933-025-02931-1
[31]	OUSSALAH A， HAGHNEJAD V， RODRIGUEZ S M， et al. Mid-regional pro-adrenomedullin： A rapid sepsis biomarker for diagnosing spontaneous bacterial peritonitis in cirrhosis［J］. Eur J Clin Invest， 2025， 55（6）： e70021-e70021. doi： 10.1111/ECI. 70021 . doi: 10.1111/ECI. 70021
[32]	MATTIA L， MARCO M D， ROBERTA A， et al. Long Pentraxin 3 as a New Biomarker for Diagnosis of Hip and Knee Periprosthetic Joint Infections［J］. J Clin Med， 2023， 12（3）： 1055-1055. doi： 10.3390/JCM12031055 . doi: 10.3390/JCM12031055

指标	轻度组（n = 36）	中度组（n = 45）	重度组（n = 31）	F/χ²值	P值
BMI/（kg/m²）	23.47 ± 1.14	23.25 ± 1.09	23.11 ± 1.05	0.931	0.397
年龄/岁	72.55 ± 2.15	72.94 ± 2.33	73.15 ± 2.27	0.622	0.539
性别/［例（%）］				0.062	0.970
男	21（58.33）	27（60.00）	19（61.29）
女	15（41.67）	18（40.00）	12（38.71）
卒中类型/［例（%）］				1.340	0.512
脑梗死	29（80.56）	37（82.22）	28（90.32）
脑出血	7（19.44）	8（17.78）	3（9.68）
饮酒史/［例（%）］				0.050	0.975
有	13（36.11）	17（37.78）	12（38.71）
无	23（63.89）	28（62.22）	19（61.29）
吸烟史/［例（%）］				1.896	0.388
有	10（27.78）	13（28.89）	13（41.94）
无	26（72.22）	32（71.11）	18（58.06）
接受教育年限/年	8.56 ± 1.45	8.13 ± 1.25	7.96 ± 1.32	1.854	0.162
sCD163/（ng/mL）	474.69 ± 54.23	583.11 ± 60.78^a	682.25 ± 65.49^ab	99.795	< 0.001
SHR	0.95 ± 0.24	1.22 ± 0.33^a	1.61 ± 0.38^ab	35.663	< 0.001
pro-ADM/（nmol/L）	1.51 ± 0.22	1.85 ± 0.24^a	2.16 ± 0.27^ab	60.137	< 0.001
PTX3/（ng/mL）	14.65 ± 3.12	20.29 ± 4.18^a	28.33 ± 5.46^ab	85.129	< 0.001
胸部CT评分/分	3.72 ± 0.67	5.93 ± 1.05^a	8.45 ± 1.22^ab	186.552	< 0.001

指标	预后良好组（n = 77）	预后不良组（n = 35）	t/χ² 值	P值
BMI/（kg/m²）	23.34 ± 1.11	23.15 ± 1.07	0.849	0.398
年龄/岁	73.02 ± 2.35	72.55 ± 2.27	0.991	0.324
性别/［例（%）］			0.736	0.391
男	44（57.14）	23（65.71）
女	33（42.86）	12（34.29）
卒中类型/［例（%）］			0.814	0.367
脑梗死	63（81.82）	31（88.57）
脑出血	14（18.18）	4（11.43）
饮酒史/［例（%）］			0.623	0.430
有	27（35.06）	15（42.86）
无	50（64.94）	20（57.14）
吸烟史/［例（%）］			0.584	0.445
有	23（29.87）	13（37.14）
无	54（70.13）	22（62.86）
接受教育年限/年	8.31 ± 1.33	8.03 ± 1.25	1.052	0.295
sCD163/（ng/mL）	492.58 ± 155.38	758.57 ± 168.93	8.171	< 0.001
SHR	1.15 ± 0.22	1.44 ± 0.35	5.327	< 0.001
pro-ADM/（nmol/L）	1.63 ± 0.15	2.26 ± 0.21	18.092	< 0.001
PTX3/（ng/mL）	16.28 ± 3.07	30.43 ± 4.56	19.297	< 0.001
胸部CT评分/分	4.02 ± 1.26	10.09 ± 2.54	3.501	< 0.001

指标	AUC	95%CI	P值	敏感度/%	特异度/%	约登指数
sCD163	0.803	0.718 ~ 0.872	< 0.001	71.43	77.92	0.494
SHR	0.758	0.668 ~ 0.834	< 0.001	71.43	71.43	0.429
pro-ADM	0.786	0.698 ~ 0.858	< 0.001	71.43	85.32	0.468
PTX3	0.787	0.700 ~ 0.859	< 0.001	68.57	83.12	0.517
胸部CT评分	0.752	0.661 ~ 0.828	< 0.001	68.57	71.43	0.400
联合检测	0.903^cdefg	0.832 ~ 0.951	< 0.001	82.86	89.61	0.725

Evaluation value of sCD163， SHR， pro-ADM， PTX3 combined with score of chest CT on the condition and prognosis of elderly patients with stroke-related pneumonia

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 8

References 32

Related Articles 15

Recommended Articles

Metrics

Comments

指标	胸部CT评分
指标	r值	P值
sCD163	0.775	< 0.001
SHR	0.615	0.015
pro-ADM	0.825	< 0.001
PTX3	0.866	< 0.001

[1]	Wen LI,Haisheng HUANG,Bin HUANG,Li HAN. Expression correlation of PD⁃L1 and Her⁃2 in invasive urothelial carcinoma and their impact on prognosis [J]. The Journal of Practical Medicine, 2026, 42(2): 194-200.
[2]	Xin LIU,Hongrui ZHANG,Ying SHEN,Yuqiao DIAO,Tao FAN. Correlation of serum lncRNA THRIL， lncRNA NEAT1 with the severity and prognosis of neonatal pneumonia [J]. The Journal of Practical Medicine, 2026, 42(2): 327-333.
[3]	Xinghua BIAN,Peng XU,Junfei SHI,Zhenhua MA. The predictive value of serum matrix metalloproteinase-2， myeloperoxidase， axonal guidance factor 3E for the prognosis of patients undergoing intracranial aneurysm clipping surgery under general anesthesia [J]. The Journal of Practical Medicine, 2026, 42(1): 56-63.
[4]	Yingdao CHEN,Haining LI,Yuying LI,Qiping ZHANG,Bingsong LIANG,Guohui. LI. The predictive value of serum miR-143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction after thrombolysis [J]. The Journal of Practical Medicine, 2025, 41(8): 1117-1122.
[5]	Juan SHEN,Yong WANG,Qiuping WANG,Chen. LING. Relationship between the immune status of patients with multiple myeloma and the changes in the levels of detection of peripheral blood RDW-SD， sBCMA， sFLCR and prognosis [J]. The Journal of Practical Medicine, 2025, 41(8): 1161-1166.
[6]	Yin GUO,Haiqing REN,Xiaoyang GUO,Jianghua ZUO,Ting. WANG. Study on the correlation between serum APRIL， PLA2R⁃Ab， and 25⁃（OH） D₃ levels and the severity and prognosis of primary membranous nephropathy [J]. The Journal of Practical Medicine, 2025, 41(8): 1199-1204.
[7]	Weixiang FENG,Juan WANG,Yanbin SONG,Sheliang XUE,Wenhua LI. The long⁃term prognosis of nonparoxysmal atrial fibrillation （NPAF） patients after radiofrequency catheter ablation [J]. The Journal of Practical Medicine, 2025, 41(7): 1036-1043.
[8]	Fuxia ZHENG,Lijun MIAO,Fengxiang HUANG,Shifu HUANG,Zengyan GAO,Ruixia ZHANG,Yong MENG. The correlation between the levels of APC， TXB2， and sB7⁃H3 in peripheral blood of elderly patients with pneumonia and the severity and prognosis of the disease [J]. The Journal of Practical Medicine, 2025, 41(7): 1056-1061.
[9]	Chunmei MA,Zhikang WU,Ke CHEN,Ziyan WANG,Yu WANG,Lian WANG. Effect of pulmonary artery to aorta diameter ratio on prognosis in patients with acute decompensated heart failure [J]. The Journal of Practical Medicine, 2025, 41(7): 960-967.
[10]	Tong DUAN,Qi WU,Hui. LIU. Correlation between iron death⁃related gene expression level and myocardial dysfunction and prognosis in sepsis [J]. The Journal of Practical Medicine, 2025, 41(6): 846-851.
[11]	Zhuolin YAO,Zhen LI,Caihua ZHANG,Mingmei ZHANG,Ruolin JIA,Yuan CAO,Yiping WANG,Yichun. GUAN. Analysis of clinical outcome of IVF/ICSI with dual⁃stimulation protocol in POSEIDON patients with low expected prognosis [J]. The Journal of Practical Medicine, 2025, 41(4): 580-588.
[12]	Shenglei ZHANG,Ruicong TIAN,Jingjing JIN,Fan LU,Meijuan CHENG,Yaling BAI,Jinsheng. XU. To study the relationship between lymphocyte subsets and renal clinicopathological features and prognosis in patients with IgA nephropathy [J]. The Journal of Practical Medicine, 2025, 41(3): 352-357.
[13]	Yiyang ZHAI,Yunyi MA,Junying ZHAI,Hongli NIU,Ying. WANG. The relationship between tumor necrosis factor alpha inducible protein 8 family members 2， cell proliferation nuclear antigen expression levels， and clinical pathological parameters and prognosis in endometrial cancer tissue [J]. The Journal of Practical Medicine, 2025, 41(3): 379-384.
[14]	Danping WANG,Yufeng CAI,Dehua HU,Liang. ZHANG. The role of LncRNA RMST in gastric cancer： Expression levels， diagnostic value， and prognostic implicationssion [J]. The Journal of Practical Medicine, 2025, 41(3): 409-413.
[15]	Yebao WANG,Yongping LIN,Ling LIU,Jianmin. LI. Correlation of serum miR‑210， TSG‑6 and CTRP3 with myocardial fibrosis and prognosis in patients with dilated cardiomyopathy [J]. The Journal of Practical Medicine, 2025, 41(23): 3690-3696.