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