外周血CD64感染指数、IL-6与多药耐药鲍曼不动杆菌血流感染预后关系研究  

Relationship between peripheral blood CD64 infection index,IL-6 and prognosis of patients with multidrug resistant Acinetobacter baumannii bloodstream infection

作　　者：张友华[1] 蔡天斌[1] 吕光宇[1] ZHANG Youhua;CAI Tianbin;LV Guangyu(Department of Intensive Care Medicine,Liuzhou People's Hospital,Liuzhou 545006,Guangxi,China)

机构地区：[1]柳州市人民医院重症医学科,广西柳州545006

出　　处：《中国病原生物学杂志》2023年第5期561-565,共5页Journal of Pathogen Biology

基　　金：广西壮族自治区医疗卫生重点学科建设项目(No.2019-19)。

摘　　要：目的探究外周血CD64感染指数、白细胞介素-6(IL-6)与多药耐药鲍曼不动杆菌血流感染患者预后的关系。方法选取本院自2017年10月至2022年10月收诊的102例多药耐药鲍曼不动杆菌血流感染患者为研究组,根据患者预后情况分为预后不良组(n=57)和预后良好组(n=45),另选取同期98例肺部感染机械通气患者为对照组。收集临床资料并采用Cox多因素分析影响多药耐药鲍曼不动杆菌血流感染患者预后的因素;受试者工作特征(ROC)曲线分析外周血CD64感染指数和IL-6水平对多药耐药鲍曼不动杆菌血流感染患者预后的预测价值。结果与对照组相比,研究组外周血CD64感染指数、IL-6水平均明显升高(均P<0.05)。与预后良好组相比,预后不良组外周血CD64感染指数、IL-6水平均明显升高(均P<0.05)。合并免疫抑制状态、抗菌药物使用类型≥3种、急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分、机械通气时间、CD64感染指数和IL-6是影响多药耐药鲍曼不动杆菌血流感染患者预后的独立影响因素(均P<0.05)。ROC曲线分析显示,CD64感染指数单独预测多药耐药鲍曼不动杆菌血流感染患者预后的AUC为0.869,最佳截断值为5.66,灵敏度、特异性分别为70.27%和86.99%;IL-6水平单独预测患者预后的AUC为0.836,最佳截断值为239.15 ng/L,其灵敏度、特异性分别为67.57%、86.30%,两者联合预测的AUC为0.926,显著大于CD64感染指数单独预测的AUC(Z=3.849,P=0.000)和IL-6水平单独预测的AUC(Z=2.233,P=0.026)。结论外周血CD64感染指数和IL-6水平在多药耐药鲍曼不动杆菌血流感染患者中明显升高,二者联合检测对多药耐药鲍曼不动杆菌血流感染患者的预后具有较高的预测价值。Objective To explore the relationship between CD64 infection index,interleukin-6(IL-6)and the prognosis of patients with multidrug resistant Acinetobacter baumannii bloodstream infection.Methods A total of 102 patients with multidrug resistant A.baumannii bloodstream infection admitted to our hospital from October 2017 to October 2022 were selected as the study group,according to the prognosis of patients,they were divided into poor prognosis group(n=57)and good prognosis group(n=45).In addition,98 patients with pulmonary infection and mechanical ventilation were regarded as the control group.Clinical data were collected and Cox multifactor analysis was applied to analyze the factors affecting the prognosis of patients with multidrug resistant A.baumannii bloodstream infection;ROC curve was applied to analyze the predictive value of CD64 infection index and IL-6 level in peripheral blood on the prognosis of patients with multidrug resistant A.baumannii bloodstream infection.Results Compared with the control group,the peripheral blood CD64 infection index[(6.71±1.06),(2.85±0.57)]and IL-6 levels[(206.91±22.92),(137.52±15.34)ng/L]in the study group were obviously higher(P<0.05).Compared with the good prognosis group,the peripheral blood CD64 infection index[(8.25±1.39),(4.77±0.84)]and IL-6 levels[(245.86±29.51),(157.57±16.92)ng/L]in the poor prognosis group were obviously higher(P<0.05).The prognosis of patients with multidrug resistant A.baumannii bloodstream infection was independently affected by the complicated immunosuppressive status,antibacterial drug use type≥3,Acute Physiological And Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,mechanical ventilation time,CD64 infection index and IL-6(P<0.05).ROC curve analysis showed that the AUC of CD64 infection index alone predicting the prognosis of patients with multidrug resistant A.baumannii bloodstream infection was 0.869,the best cutoff value was 5.66,and the sensitivity and specificity were 70.27%and 86.99%,respectively;the AUC of IL-6 alone in predic

关 键 词：多药耐药鲍曼不动杆菌血流感染 CD64感染指数 白细胞介素-6 预后 预测价值 

分 类 号：R378[医药卫生—病原生物学]