Plasma ESM-1 Combined With PCT And IL-6 Assay In Elderly With Severe Pneumonia Expression And Its Clinical Significance

Objective:To investigate the clinical significance of the changes in the concentrations of plasma Endothelial cell specific molecule-1（ESM-1）,Procalcitonin（PCT）and Interleukin-6（IL-6）in elderly patients with severe pneumonia.Methods:Elderly patients with severe pneumonia treated in the Department of Respiratory Medicine of Chengde Central Hospital and elderly patients with common pneumonia treated in the Department of Respiratory Medicine during November 2021-December 2022 were selected as the case group,and healthy checkups（≥65 years old）from Chengde Central Hospital were selected as the control group,and the following were collected:（1）General information（including name,sex,age,etc.）,past and present medical history,relevant auxiliary examinations,smoking history,prognosis and other clinical data were collected by interviewing patients and reviewing medical records.（2）Venous blood was taken at the time of admission（within 24hours）to test:routine blood,liver and kidney function,serum albumin（ALB）,PCT,IL-6,ESM-1,etc.,respectively.The plasma ESM-1,PCT and IL-6 levels were retested on the seventh day of admission.The operation process was standardized sampling and standardized testing.To compare plasma ESM-1,PCT and IL-6 levels in the elderly patients with severe pneumonia group and the elderly patients with common pneumonia group,paired sample t-test was used for the pre-post self-comparisons,and independent sample t-test,one-way ANOVA was used for between-group comparisons.Differences were considered statistically significant at P<0.05.Results:1.A total of 137 cases were finally included in this study meeting the inclusion criteria,including 46 elderly patients with severe pneumonia,47elderly patients with common pneumonia,and 44 elderly healthy checkups.There were no statistically significant differences in age,gender,and smoking history among the three groups of subjects（P>0.05）.The proportion of elderly patients with severe pneumonia combined with cerebrovascular disease,COPD,and diabetes was significantly higher than that of the remaining two groups,and the difference was statistically significant（P<0.05）.There was no statistically significant difference between the three groups of subjects in terms of combined hypertension and coronary artery disease（P>0.05）.2.The levels of plasma ESM-1,PCT and IL-6 were significantly different among the three groups（P>0.05）,from high to low:elderly severe pneumonia group>elderly common pneumonia group>elderly healthy checkups.The levels of plasma ALB were significantly different among the three groups（P>0.05）,from high to low:elderly healthy checkups>elderly common pneumonia group>elderly severe pneumonia group.White blood cell count（WBC）was significantly different among the three groups（P<0.05）,and the one-by-one comparisons between the groups revealed that there was no significant difference in WBC between the elderly severe pneumonia group and the elderly common pneumonia group（P>0.05）,but both were significantly higher than elderly healthy checkups（P<0.05）.3.In this study,plasma ESM-1,PCT and IL-6 were significantly lower at day 7 in both the elderly patients with severe pneumonia group and the elderly patients with common pneumonia group compared with those at the time of admission（P<0.05）.And the simultaneous plasma ESM-1,PCT and IL-6 levels were significantly higher in the elderly patients with severe pneumonia group than in the elderly patients with common pneumonia group（P<0.05）.4.In this study,plasma ESM-1 levels were positively correlated with plasma PCT and IL-6 levels（r₁=0.324,r₂=0.325,P<0.05）,negatively correlated with plasma ALB levels（r=﹣0.360,P<0.05）,and not correlated with WBC（r=0.220,P>0.05）in elderly patients with pneumonia at the time of admission.5.Area under the ROC curve（AUC）for plasma ESM-1 levels diagnosing severe pneumonia in the elderly was 75.7%,and its optimal cut-off value for the diagnosis of severe pneumonia in the elderly was 12.02ng/m L,with a sensitivity of 60.9%and specificity of 89.4%.Conclusions:1.Plasma ESM-1 levels have diagnostic value for severe pneumonia in the elderly.2.Plasma ESM-1 combined with PCT and IL-6 levels are positively correlated with the severity of severe pneumonia in the elderly.3.Continuous monitoring of plasma ESM-1 combined with PCT and IL-6 levels can reflect the development process of severe pneumonia in the elderly,assess the therapeutic effect and guide the clinical use of drugs.