心力衰竭合并肺部感染患者血清MIP-2、Cys C、miR-21表达水平及对抗感染效果的预测价值  

Serum MIP-2,Cys C and miR-21 Expression in Patients with Heart Failure Complicated with Pulmonary Infection and Their Predictive Value for Anti-infection Efficacy

作　　者：乔家林[1] 李明阳 QIAO Jialin;LI Mingyang(Department of Emergency Medicine,Shangqiu First People’s Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院急诊内科,河南商丘476000

出　　处：《河南医学研究》2022年第24期4516-4519,共4页Henan Medical Research

摘　　要：目的心力衰竭合并肺部感染(PI)患者血清巨噬细胞炎性蛋白-2(MIP-2)、胱抑素C(Cys C)、microRNA-21(miR-21)表达水平及对抗感染效果的预测价值。方法选取2019年4月至2021年10月商丘市第一人民医院收治的163例心力衰竭患者,根据是否合并PI分为心力衰竭合并PI组(n=96)、心力衰竭未合并PI组(n=67),另选取同期100例健康体检者为对照组,均检测血清MIP-2、Cys C、miR-21水平。心力衰竭患者均接受常规抗心力衰竭治疗,合并PI患者接受抗感染治疗。观察抗感染效果及临床肺部感染评分(CPIS)、序贯器官衰竭评分(SOFA)变化,分析血清MIP-2、Cys C、miR-21水平与CPIS、SOFA评分的相关性,并分析血清MIP-2、Cys C和miR-21水平对抗感染效果的预测价值。结果3组血清MIP-2、Cys C、miR-21水平对比,心力衰竭合并PI组最高,心力衰竭未合并PI组其次,对照组最低(P<0.05);心力衰竭合并PI组CPIS、SOFA评分均较心力衰竭未合并PI组高(P<0.05);CPIS、SOFA评分与血清MIP-2、Cys C、miR-21水平均呈正相关(P<0.05);治疗1、2个疗程后抗感染有效患者血清MIP-2、Cys C、miR-21水平均低于抗感染无效患者(P<0.05);治疗1个疗程后,血清MIP-2、Cys C、miR-21联合预测抗感染无效的曲线下面积为0.919(95%CI:0.837~0.946),敏感度为92.59%,特异度为91.30%(P<0.05)。结论血清MIP-2、Cys C、miR-21在心力衰竭合并PI患者血清中表达水平较高,且与感染程度、器官功能状态相关,三者联合对心力衰竭合并PI患者抗感染效果具有较高预测价值。Objective To investigate the expression of serum macrophage inflammatory protein-2(MIP-2),cystatin C(Cys C)and microRNA-21(miR-21)in patients with heart failure complicated with pulmonary infection(PI)and their resistance predictive value of infection efficacy.Methods A total of 163 patients with heart failure who were admitted in Shangqiu First People’s Hospital from April 2019 to October 2021 were selected and divided into heart failure combined with PI group(n=96)and heart failure without PI group(n=67)according to whether they were combined with PI.Another 100 healthy physical examination persons during the same period were selected as the control group,and serum MIP-2,Cys C,and miR-21 levels were detected.All patients with heart failure accepted conventional anti-heart failure treatment,and patients with PI accepted anti-infective treatment.The anti-infective efficacy,clinical pulmonary infection score(CPIS)and sequential organ failure assessment(SOFA)were observed,the correlation between serum MIP-2,Cys C,miR-21 levels and CPIS,SOFA scores,and the predictive value of serum MIP-2,Cys C and miR-21 levels of anti-infection efficacy were analyzed.Results The levels of serum MIP-2,Cys C and miR-21 in three groups were compared,and the heart failure combined with PI group was the highest,the heart failure without PI group was the second,and the control group was the lowest(P<0.05).The CPIS and SOFA scores of the heart failure combined with PI group were higher than those of the heart failure without PI group(P<0.05).CPIS and SOFA scores were positively correlated with serum MIP-2,Cys C and miR-21 levels(P<0.05).After 1 and 2 courses of treatment,the serum MIP-2,Cys C and miR-21 levels in patients with effective anti-infection were lower than those in patients with ineffective anti-infection(P<0.05).After 1 course of treatment,the area under curve value of serum MIP-2,Cys C and miR-21 combined to predict the ineffectiveness of anti-infection was 0.919(95%CI:0.837-0.946),the sensitivity was 92.59%,and the specifi

关 键 词：肺部感染 心力衰竭 胱抑素C 巨噬细胞炎性蛋白-2 MICRORNA-21 

分 类 号：R541.61[医药卫生—心血管疾病]