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通过检测成人社区获得性肺炎(CAP)患者血清可溶性程序性死亡受体配体-1(PD-L1)水平,探讨其临床意义。共纳入44例CAP患者、54例重症CAP患者和30例健康对照者,检测所有研究对象血清中可溶性PD-L1水平,单因素和多因素回归分析各临床参数对预后的影响。结果显示,重症CAP者血清可溶性PD-L1水平为98.20(57.94,128.90)ng/L,高于CAP者[59.32(33.55,92.58)ng/L]和健康对照者[20.44(12.15,36.20)ng/L](n P值均<0.001)。可溶性PD-L与CURB-65评分(n r=0.481,n P<0.001)、肺炎严重指数(PSI)评分(n r=0.442,n P<0.001)呈显著正相关。单因素回归分析显示,CURB-65评分(n HR=2.544,95%n CI 1.324~4.889,n P=0.005)、PSI评分(n HR=1.036,95%n CI 1.012~1.061,n P=0.004)、可溶性PD-L1水平(n HR=1.013,95%n CI 1.001~1.026,n P=0.041)是CAP患者住院期间死亡的危险因素。多因素回归分析显示,PSI评分(n HR=1.042,95%n CI 1.012-1.073,n P=0.005)、可溶性PD-L1水平(n HR=1.011,95%n CI 1.002~1.071,n P=0.020)是影响CAP患者死亡的独立危险因素。可溶性PD-L1≥98.20 ng/L的CAP患者住院期间生存率显著低于可溶性PD-L1<98.20 ng/L者(n P=0.033)。提示成人CAP患者血清可溶性PD-L1水平升高与预后相关,可能是影响患者预后的独立危险因素之一。n “,”To investigate the clinical significance of serum soluble programmed cell death ligand-1 (PD-L1) in adult patients with community-acquired pneumonia (CAP). A total of 44 CAP patients, 54 severe CAP patients and 30 healthy volunteers were recruited in this study. Serum soluble PD-L1 were detected. Univariate and multivariate regression analyses were used to assess the influence of multiple clinical variables on prognosis. Serum soluble PD-L1 level in severe CAP group was 98.20(57.94, 128.90) ng/L, which was significantly higher than that in the CAP group [59.32(33.55, 92.58) ng/L] and healthy controls [20.44(12.15, 36.20) ng/L] (alln P<0.001). PD-L1 level was positively correlated with CRUB-65(n r=0.481, n P<0.001) and the pneumonia severity index (PSI) score (n r=0.442, n P<0.001). Univariate regression analysis showed that CURB-65 (n HR=2.544, 95%n CI 1.324-4.889, n P=0.005), PSI score (n HR=1.036, 95%n CI 1.012-1.061, n P=0.004), soluble PD-L1(n HR=1.013, 95%n CI 1.001-1.026, n P=0.041) were risk factors of mortality during hospitalization. Multivariate regression analysis suggested that PSI score (n HR=1.042, 95%n CI 1.012-1.073, n P=0.005), soluble PD-L1 (n HR=1.011, 95%n CI 1.002-1.071, n P=0.020) were independent predictors for mortality risk in CAP patients. CAP patients with soluble PD-L1≥98.20 ng/L had a significantly lower survival rate than those with soluble PD-L1<98.20 ng/L (n P=0.033). In conclusion, this study indicates that serum soluble PD-L1 level in CAP patients is correlated with the survival prognosis.n