急性心肌梗死并发医院感染患者外周血miR-19b和IL-37水平及预后影响因素  

Peripheral blood miR-19b and IL-37 in patients with acute myocardial infarction complicated by nosocomial infection and risk factors for prognosis

作　　者：林燕仔 张光星[1] 郑婉 魏俊萍 符惠丽 林明霞[2] 唐利龙 LIN Yan-zai;ZHANG Guang-xing;ZHENG Wan;WEIJun-ping;FU Hui-li;LIN Ming-xia;TANG Li-long(The First Affiliated Hospital of Hainan Medical College,Haikou,Hainan570100,China)

机构地区：[1]海南医学院第一附属医院心血管内科,海南海口570100 [2]海南医学院第一附属医院心电图室,海南海口570100

出　　处：《中华医院感染学杂志》2021年第11期1629-1633,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81960075);海南省基础与应用基础研究计划(自然科学领域)高层次人才基金资助项目(2019RC377)。

摘　　要：目的分析急性心肌梗死并发医院感染患者外周血miR-19b、白细胞介素-37(IL-37)的表达水平及预后的影响因素。方法选择2017年1月-2019年12月海南医学院第一附属医院心血管内科收治的68例急性心肌梗死并发医院感染患者设为感染组,另选择同期收治的68例急性心肌梗死无医院感染患者设为未感染组,比较两组患者外周血miR-19b、IL-37水平。依据预后情况将感染组患者分为预后良好患者和预后不良患者,分析不同预后患者临床资料,归纳急性心肌梗死并发医院感染患者预后不良的影响因素。结果感染组外周血miR-19b、IL-37分别为(3.47±0.84)、(41.65±6.48)ng/ml均高于未感染组(P<0.001)。68例急性心肌梗死并发医院感染患者中,预后良好52例,预后不良16例。急性心肌梗死并发医院感染预后良好患者糖尿病史、慢性阻塞性肺疾病(COPD)史、心功能分级、卧床时间与预后不良患者比较差异有统计学意义(P<0.05),且不良预后组患者外周血miR-19b、IL-37水平均高于预后良好患者(P<0.05)。多因素Logistic回归分析显示,miR-19b是急性心肌梗死并发医院感染患者预后不良的影响因素(OR=2.552,95%CI:1.193~5.460,P=0.016)。结论急性心肌梗死并发医院感染患者外周血miR-19b、IL-37水平较高,miR-19b为急性心肌梗死并发医院感染患者预后不良的影响因素。OBJECTIVE To analyze the expression of miR-19 b and interleukin-37(IL-37)levels in peripheral blood of patients with acute myocardial infarction(AMI)complicated by nosocomial infection and their risk factor with prognosis.METHODS From Jan.2017 to Dec.2019,68 patients with AMI complicated by nosocomial infection admitted to the department of cardiology at the First Affiliated Hospital of Hainan Medical College were selected as the infection group,and 68 AMI patients without nosocomial infection during the same period were selected as the non-infection group.The levels of miR-19 b and IL-37 in peripheral blood of both groups were measured and compared.According to the prognosis,patients in the infection group were divided into good prognosis group and poor prognosis group.The clinical data of patients with different prognosis were analyzed,and the factors affecting the poor prognosis of patients with AMI complicated by nosocomial infection were summarized.RESULTS The peripheral blood miR-19 b and IL-37 in the infection group were(3.47±0.84)and(41.65±6.48)ng/ml,respectively,higher than those in the non-infection group(P<0.001).Among the 68 patients with AMI complicated by nosocomial infection,there were 52 cases with good prognosis and 16 cases(23.53%)with poor prognosis.Compared with patients in the poor prognosis group,patients with AMI complicated by nosocomial infection in the good prognosis group had significant differences in diabetes history,COPD history,cardiac function classification and bed rest time(P<0.05),and the peripheral blood miR-19 b and IL-37 in the poor prognosis group were significanttly higher than those in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that miR-19 b was a risk factor for poor prognosis of patients with AMI complicated by nosocomial infection(OR=2.552,95%CI:1.193~5.460,P=0.016).CONCLUSION Peripheral blood miR-19 b and IL-37 were higher in patients with AMI complicated by nosocomial infection,and miR-19 b was an influencing factor for the poo

关 键 词：急性心肌梗死 医院感染 miR-19b 白细胞介素-37 预后 危险因素 

分 类 号：R542.22[医药卫生—心血管疾病]