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在免疫功能低下的患者中, Pseudomonas LRTI 的风险分层:具有临床影响的 LASSO-逻辑回归模型

Xiao Ge^1,2, Chengjun Gan³, Xu Han⁴

¹Department of Respiratory and Critical Care Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Shanghai, China.

|August 19, 2025

概括

六个生物标志物,包括中性粒细胞数量和D-二次体与淋巴细胞比率 (DLR),预测了患有Pseudomonas aeruginosa下呼吸道感染 (LRTI) 的免疫功能低下的成年人的28天死亡率. 中性粒细胞-DLR-AST模型提供了早期风险分层.

科学领域:

传染性疾病传染性疾病
关键护理医学关键护理医学
生物标志物和诊断方法

背景情况:

免疫功能低下的患者面临来自Pseudomonas aeruginosa下呼吸道感染 (LRTI) 的高死亡率.
预测这些患者的死亡率对于及时干预和资源分配至关重要.

研究的目的:

确定与P. aeruginosa LRTIs免疫功能低下的成年人28天死亡率的独立预测因素.
开发和验证死亡风险分层的预测模型.

主要方法:

对177名免疫功能低下的成年人进行了回顾性队列研究,他们接受了P. aeruginosa LRTIs.
通过LASSO和后勤回归分析,从19个临床和实验室变量中确定了死亡率预测因素.
接收器操作特征 (ROC) 分析评估了模型性能.

主要成果:

确定了28天死亡率的六个独立预测因素:中性粒细胞数量,D-二聚体与淋巴细胞比率 (DLR),阿斯巴酸氨基转移酶 (AST),年龄,红细胞分布宽度 (RDW) 和血小板与淋巴细胞比率 (PLR).
开发的模型显示强大的歧视 (AUC = 0.792),具有高灵敏度 (91.9%) 和特异性 (89.5%).
一个新的中性粒细胞数量,DLR和AST的预后三位数出现,反映了炎症,凝血病和肝脏压力.

结论:

这项研究确定了可访问的生物标志物,用于P. aeruginosa LRTI.免疫受损患者的死亡风险分层.
中性粒细胞-DLR-AST三元组为早期识别高风险患者提供了一种新的预后模型.
未来的验证和进一步研究病理生理机制是有必要的.

关键词:

这是一个LASSO-逻辑回归.免疫功能低下的患者.这是下呼吸道感染.预后生物标志物预后生物标志物

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