Abstract: Objective To investigate the correlation between CD40 ligand (CD40L), soluble FMS like tyrosine kinase receptor-1 (sFlt-1), salivary liquefied sugar chain antigen-6 (KL-6) and the prognosis of patients with severe pneumonia (SP). Methods Ninety-eight SP patients admitted to Zhengzhou Third People's Hospital from January 2020 to December 2022 were selected as the study objects. According to the disease outcomes 28 days after admission, the patients were divided into a good outcome group (69 cases) and a poor outcome group (29 cases). Serum levels of CD40L, sFLT-1 and KL-6 were compared between the two groups, and the pulmonary function indicators [forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow (PEF)] of the two groups were compared, and the correlation between the levels of serum indicators and pulmonary function indicators and disease outcomes was analyzed, and the risk of adverse outcomes of patients with different levels of indicators was analyzed. Results After 7 and 14 days of treatment, the levels of CD40L, sFLT-1 and KL-6 in the poor group were higher than those in the good group, and the levels of FVC, FEV1 and PEF were lower than those in the good group (P<0.05). Serum CD40L, sFLT-1 and KL-6 levels were negatively correlated with disease outcome, FVC, FEV1 and PEF after 7 and 14 days of treatment (P<0.05). After 14 days of treatment, the risk of adverse outcomes in patients with high levels of serum CD40L, sFLT-1 and KL-6 was 3.255, 3.911 and 2.322 times that of low levels, respectively (P<0.05). Conclusion Serum CD40L, sFLT-1 and KL-6 levels are closely related to the disease outcome of SP patients, and can be used as effective indicators to predict the outcome of SP patients.

Key words: severe pneumonia, disease outcome, CD40L, sFLT-1, KL-6

摘要： 目的 探讨CD40配体（CD40L）、可溶性fms样酪氨酸激酶受体-1（sFLT-1）、涎液化糖链抗原-6（KL-6）与重症肺炎（SP）患者疾病转归的相关性研究。方法 选取2020年1月~2022年12月郑州市第三人民医院收治的98例SP患者为研究对象,根据入院后28 d疾病转归情况将患者分为转归良好组（69例）和转归不良组（29例）。比较2组血清CD40L、sFLT-1、KL-6水平和肺功能指标[用力肺活量（FVC）、第1秒用力呼气量（FEV1）、最高呼气流速（PEF）],分析血清各指标水平与肺功能指标及疾病转归的相关性,分析各指标不同水平患者转归不良的危险度。结果 治疗7 d、14 d后转归不良组血清CD40L、sFLT-1、KL-6水平高于转归良好组,FVC、FEV1、PEF低于转归良好组（P<0.05）;治疗7 d、14 d后血清CD40L、sFLT-1、KL-6水平与疾病转归、FVC、FEV1、PEF均呈负相关（P<0.05）;治疗14d后血清CD40L、sFLT-1、KL-6高水平患者转归不良危险度分别是低水平的3.255、3.911、2.322倍（P<0.05）。结论 血清CD40L、sFLT-1、KL-6水平与SP患者疾病转归密切相关,可作为临床预测转归情况的有效指标。

关键词: 重症肺炎, 疾病转归, CD40L, sFLT-1, KL-6