Cheng Xiangkuan, Liu Lanling, Tian Yueming, Lin Yuansheng
Department Care Unit, Hebei Yanda Lu Daopei Hospital, Langfang, 065201, Hebei Province, China.
Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Sci Rep. 2025 May 14;15(1):16806. doi: 10.1038/s41598-025-01721-9.
Elevated serum lactate dehydrogenase (LDH) levels have been associated with poor prognosis in various diseases. This study investigates the relationship between serum LDH levels and 90-day mortality in patients with connective tissue disease (CTD) receiving glucocorticoids and hospitalized with pneumonia. A total of 298 CTD patients were included in this study. The cohort was divided into three groups based on serum LDH levels (Group 1: < 246 U/L, 0% mortality; Group 2: 246-407 U/L, 26% mortality; Group 3: ≥ 407 U/L, 48% mortality). Clinical and laboratory data were analyzed to evaluate the association between LDH levels and 90-day mortality using Kaplan-Meier survival curves, Cox regression models, and subgroup analyses. Elevated LDH levels were significantly associated with increased mortality. The Kaplan-Meier survival analysis demonstrated that patients in Group 3 (highest LDH levels) had the highest 90-day mortality rate, while those in Group 1 (lowest LDH levels) had the lowest (p < 0.0001). Multivariate Cox regression analysis revealed that every 100 U/L increase in LDH was associated with a higher risk of mortality (HR 1.07, 95% CI 1.01-1.13, p = 0.02). Patients in Group 3 showed a significantly increased risk of mortality (HR 2.29, 95% CI 1.06-4.96, p = 0.036). The subgroup analyses demonstrated stable results across different clinical subgroups. Elevated serum LDH levels, particularly in Group 3, are independently associated with increased 90-day mortality in CTD patients receiving glucocorticoids and hospitalized with pneumonia. LDH may serve as an important prognostic marker for these patients.
血清乳酸脱氢酶（LDH）水平升高与多种疾病的不良预后相关。本研究调查了接受糖皮质激素治疗并因肺炎住院的结缔组织病（CTD）患者血清LDH水平与90天死亡率之间的关系。本研究共纳入298例CTD患者。根据血清LDH水平将队列分为三组（第1组：<246 U/L，死亡率为0%；第2组：246 - 407 U/L，死亡率为26%；第3组：≥407 U/L，死亡率为48%）。使用Kaplan-Meier生存曲线、Cox回归模型和亚组分析对临床和实验室数据进行分析，以评估LDH水平与90天死亡率之间的关联。LDH水平升高与死亡率增加显著相关。Kaplan-Meier生存分析表明，第3组（LDH水平最高）患者的90天死亡率最高，而第1组（LDH水平最低）患者的死亡率最低（p < 0.0001）。多变量Cox回归分析显示，LDH每升高100 U/L，死亡风险就会增加（风险比1.07，95%置信区间1.01 - 1.13，p = 0.02）。第3组患者的死亡风险显著增加（风险比2.29，95%置信区间1.06 - 4.96，p = 0.036）。亚组分析在不同临床亚组中显示出稳定的结果。血清LDH水平升高（特别是在第3组）与接受糖皮质激素治疗并因肺炎住院的CTD患者90天死亡率增加独立相关。LDH可能是这些患者的重要预后标志物。
