脑出血术后肺部感染外周血中性粒细胞mGluR5和CD_(4)^(+)T细胞A_(2A)R表达水平及意义  

Expression of neutrophil mGluR5 and CD_(4)^(+)T cell A_(2A)R in peripheral blood of cerebral hemorrhage patients with postoperative pulmonary infection and significance

作　　者：席东海 张睿 陈孝顺 沈路 肖杰 王晓宇 XI Dong-hai;ZHANG Rui;CHEN Xiao-shun;SHEN Lu;XIAO Jie;WANG Xiao-yu(The First People's Hospital of Bijie City,Bijie,Guizhou 551700,China)

机构地区：[1]贵州省毕节市第一人民医院神经外科,贵州毕节551700

出　　处：《中华医院感染学杂志》2022年第10期1504-1508,共5页Chinese Journal of Nosocomiology

基　　金：贵州省自然科学基金资助项目(2019863)。

摘　　要：目的 探究高血压脑出血术后肺部感染患者外周血中性粒细胞代谢性谷氨酸受体第5亚型(mGluR5)和CD_(4)^(+)T细胞腺苷2A受体(A_(2A)R)表达水平及意义。方法 选取2016年11月-2018年11月贵州省毕节市第一人民医院收治的高血压脑出血患者97例,根据术后是否发生肺部感染分为感染组46例,非感染组51例,分析两组患者外周血中性粒细胞mGluR5与CD_(4)^(+)T细胞A_(2A)R表达及其预测术后肺部感染的临床价值,并筛选肺部感染危险因素,比较炎症因子降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)水平差异。结果 感染患者共分离病原菌52株,其中革兰阳性菌29株占55.77%,革兰阴性菌20株占38.46%,真菌3株占5.77%,感染组中性粒细胞mGluR5及CD_(4)^(+)细胞A_(2A)R表达高于非感染组(P<0.05),PCT、CRP、TNF-α及IL-6水平高于非感染组(P<0.05),多因素分析结果,出血量、GCS评分、吸烟史、呼吸系统疾病、机械通气时间均为肺部感染的危险因素(P<0.05),受试者工作特征曲线(ROC)结果,中性粒细胞mGluR5与CD_(4)^(+)细胞A_(2A)R表达预测术后肺部感染曲线下面积为0.818与0.781。结论 中性粒细胞mGluR5及CD_(4)^(+)细胞A_(2A)R表达与高血压脑出血患者术后肺部感染发生密切相关,可为感染防治提供新的思路。OBJECTIVE To explore the expression of neutrophil metabotropic glutamate receptor 5(mGluR5) and CD_(4)^(+)T cell adenosine 2 A receptor(A_(2A)R) in peripheral blood of hypertensive intracerebral hemorrhage patients with postoperative pulmonary infection and analyze the clinical significance. METHODS A total of 97 patients with hypertensive intracerebral hemorrhage who were treated in the First People′s Hospital of Bijie City from Nov 2016 to Nov 2018 were enrolled in the study and were divided into the infection group with 46 cases and the no infection group with 51 cases according to the status of postoperative pulmonary infection. The expression levels of neutrophil mGluR5 and CD_(4)^(+)cell A_(2A)R in peripheral blood of the two groups of patients were observed, the clinical values of the two indexes in prediction of postoperative pulmonary infection were analyzed, the risk factors for the pulmonary infection were screened out, the levels of inflammatory factors procalcitonin(PCT), C-reactive protein(CRP), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were compared between the two groups of patients. RESULTS Totally 52 strains of pathogens were isolated from the patients with infection, 29(55.77%) of which were gram-positive bacteria, 20(38.46%) were gram-negative bacteria, and 3(5.77%) were fungi. The expression levels of neutrophil mGluR5 and CD_(4)^(+)cell A_(2A)R of the infection group were higher than those of the no infection group(P<0.05);the levels of PCT, CRP, TNF-α and IL-6 of the infection group were higher than those of the no infection group(P<0.05). The result of multivariate analysis showed that the hemorrhage volume, GCS score, smoking history, respiratory system disease and mechanical ventilation duration were the risk factors for the pulmonary infection(P<0.05). The result of receiver operating characteristic(ROC) curve analysis indicated that the areas under curves(AUCs) of the neutrophil mGluR5 and CD_(4)^(+)cell A_(2A)R were respectively 0.818 and 0.781 in prediction of posto

关 键 词：高血压脑出血 肺部感染 代谢性谷氨酸受体第5亚型 腺苷2A受体 预测价值 

分 类 号：R619.3[医药卫生—外科学]