Abstract：Objective: To analyze the relationship between serum amyloid a (SAA), procalcitonin (PCT), plasma fibronectin (FN), retinol binding protein (RBP) and disease severity, prognosis in elderly patients with pneumonia.Methods: A retrospective analysis was performed on the clinical data of 85 elderly patients with pneumonia in the hospital between April 2021 and April 2024. According to prognosis, patients were divided into good prognosis group (60 cases) and poor prognosis group (25 cases). After admission, levels of blood indexes [PCT, SAA, RBP, hemoglobin (Hb), FN, albumin (ALB), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), β2 microglobulin], hemocytes [white blood cell count (WBC), neutrophil ratio, lymphocyte ratio, platelets] and blood gas indexes [partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), bicarbonate ion concentration (HCO3-), base excess (BE), blood lactate concentration (Lac)], and scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) were compared between the two groups. The correlation between blood indexes and APACHE Ⅱ score was analyzed by Spearman correlation analysis. The blood indexes affecting the prognosis of elderly patients with pneumonia were analyzed with Logistic regression analysis. The prognostic value of relevant indexes was analyzed with ROC curves.Results: The levels of PCT, SAA, IL-6, hs-CRP, RBP and β2 microglobulin in the poor prognosis group were higher than those in the good prognosis group, and the levels of ALB and FN were lower than those in the good prognosis group (P<0.05). APACHE Ⅱ score was higher in poor prognosis group (P<0.05). The results of Spearman correlation analysis showed that levels of serum PCT, SAA and RBP were positively correlated with APACHE Ⅱ score, while FN level was negatively correlated with it (P<0.05). The results of Logistic regression analysis showed that serum PCT, SAA, FN and RBP were all influencing factors of prognosis in elderly patients with pneumonia (P<0.05). The results of ROC curves analysis showed that serum PCT (AUC=0.819), SAA (AUC=0.775), FN (AUC=0.792) and RBP (AUC=0.736) were all of good predictive value in prognosis of elderly patients with pneumonia (P<0.05).Conclusion: The higher the levels of serum SAA, PCT and RBP, and the lower the FN level, the severer the disease and the worse the prognosis in elderly patients with pneumonia, and all the above four indexes have good prognostic value for elderly patients with pneumonia.
2024, Vol. 30 
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