脑梗死并发MDRO感染IL-23和IL-17与sIL-2R表达及预后评价  

Expression of IL-23, IL-17 and sIL-2R in cerebral infarction patients complicated with MDRO infection and its association with prognosis

作　　者：魏杰[1] 赵霞[1] 李艳[1] 任崇 罗凯楠 WEI Jie;ZHAO Xia;LI Yan;REN Chong;LUO Kai-nan(Nanyang Medical College,Nanyang,Henan473000,China)

机构地区：[1]南阳医学高等专科学校护理系,河南南阳473000 [2]南阳医学高等专科学校第二附属医院神经内科,河南南阳473000

出　　处：《中华医院感染学杂志》2021年第13期2016-2020,共5页Chinese Journal of Nosocomiology

基　　金：河南省中医药科学研究专项基金资助项目(2016ZY3037)。

摘　　要：目的探究脑梗死(CI)并发多药耐药菌(MDRO)感染患者血清白细胞介素(IL)-23、IL-17、可溶性白细胞介素-2受体(sIL-2R)表达水平及预后评价。方法以南阳医学高等专科学校第二附属医院2016年7月-2019年7月收治130例脑梗死并发普通感染、142例脑梗死并发MDRO感染患者作为研究对象,分别为普通感染组、MDRO感染组。测定血清IL-23、IL-17、sIL-2R水平,比较两组血清指标水平,分析其对于MDRO感染的评估价值;评估MDRO感染组患者病情转归与预后情况,对影响患者病情转归因素进行分析,比较不同预后患者血清IL-23、IL-17、sIL-2R水平,评估三指标对于MDRO患者预后预测价值。结果 MDRO感染组血清IL-23、IL-17、sIL-2R水平高于普通感染组(P<0.05);受试者工作特征(ROC)曲线结果显示血清IL-23、IL-17、sIL-2R水平评估MDRO感染曲线下面积(AUC)分别为0.966、0.966、0.892;Logistic回归分析结果显示吞咽障碍、预先应用碳青霉烯类药物是MDRO患者病情转归的危险因素(P<0.05);预后良好组患者血清IL-23、IL-17、sIL-2R水平低于预后不良组患者(P<0.05);ROC曲线结果显示血清IL-23、IL-17、sIL-2R水平预测MDRO感染患者预后AUC分别为0.766、0.820、0.620。结论 MDRO感染患者血清IL-23、IL-17、sIL-2R异常上升,与患者病情转归以及预后关系密切,在评价患者病情以及预后上具有一定价值。OBJECTIVE To explore the expression of serum interleukin(IL)-23, IL-17 and soluble interleukin-2 receptor(sIL-2 R) in cerebral infarction(CI) patients complicated with multidrug-resistant organism(MDRO) infection and analyze its association with prognosis. METHODS Totally 130 CI patients complicated with common infection and 142 CI patients complicated with MDRO infection who were treated in the Second Affiliated Hospital of Nanyang Medical College from Jul 2016 to Jul 2019 were recruited as the study objects and were assigned as the common infection group and the MDRO infection group. The levels of serum IL-23, IL-17 and sIL-2 R were determined, the levels of serological indexes were compared between the two groups, the value of the indexes in assessment of MDRO infection was analyzed. The treatment outcomes and prognosis of the patients with MDRO infection were evaluated, the influencing factors for the treatment outcomes were analyzed, the levels of serum IL-23, IL-17 and sIL-2 R were compared among the patients with different treatment outcomes, and the value of the three indexes in prediction of prognosis of the patients with MDRO infection was evaluated. RESULTS The levels of serum IL-23, IL-17 and sIL-2 R of the MDRO infection group were significantly higher than those of the common infection group(P<0.05). The result of receiver operating characteristic(ROC) curve analysis showed that the areas under curve(AUCs) of the serum IL-23, IL-17 and sIL-2 R were respectively 0.966, 0.966 and 0.892 in assessment of MDRO infection. The result of logistic regression analysis indicated that dysphagia and preemptive use of carbapenems were the risk factors for the treatment outcomes of the patients with MDRO infection(P<0.05). The levels of serum IL-23, IL-17 and sIL-2 R of the patients with favorable prognosis were significantly lower than those of the patients with unfavorable prognosis(P<0.05). ROC curve analysis showed that the AUCs of the serum IL-23, IL-17 and sIL-2 R were respectively 0.766, 0.820 and 0.620 in

关 键 词：脑梗死 多药耐药菌感染 白细胞介素-23 白细胞介素-17 可溶性白细胞介素-2受体 病情转归 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]