老年心力衰竭患者肺部感染危险因素及MIP-2与miR-21和miR-129的预测价值  

Risk factors for pulmonary infection in elderly patients with heart failure and the predictive value of MIP-2,miR-21 and miR-129

作　　者：吴向春[1] 黄虎翔[2] 王斐[3] 童凯[2] 沈正军[4] WU Xiang-chun;HUANG Hu-xiang;WANG Fei;TONG Kai;SHEN Zheng-jun(Huanggang Central Hospital,Dabie Mountain Regional Medical Center,Hubei Province,Huanggang,Hubei 438000,China)

机构地区：[1]湖北省大别山区域医疗中心黄冈市中心医院医疗保健保障科,湖北黄冈438000 [2]湖北省大别山区域医疗中心黄冈市中心医院呼吸与危重症医学科,湖北黄冈438000 [3]湖北省大别山区域医疗中心黄冈市中心医院心电图室,湖北黄冈438000 [4]湖北省大别山区域医疗中心黄冈市中心医院心内科,湖北黄冈438000

出　　处：《中华医院感染学杂志》2023年第19期2896-2900,共5页Chinese Journal of Nosocomiology

基　　金：湖北省健康卫生委员会基金资助项目(2021KL0231)。

摘　　要：目的研究老年心力衰竭患者肺部感染的危险因素及巨噬细胞炎性蛋白-2(MIP-2)、微小核糖核酸-21(miR-21)、miR-129的预测价值.方法回顾性收集2020年1月-2022年7月湖北省大别山区域医疗中心黄冈市中心医院收治的229例老年心力衰竭患者临床资料,根据患者是否发生肺部感染分为感染组(n=103)和未感染组(n=126例),归纳老年心力衰竭患者肺部感染的危险因素,采用受试者工作特征(ROC)曲线分析血清MIP-2、miR-21、miR-129对老年心力衰竭患者肺部感染的预测价值.结果年龄、合并糖尿病、侵入性操作、miR-21、miR-129是老年心力衰竭患者肺部感染的危险因素(P<0.05);感染组白细胞计数、中性粒细胞百分比、淋巴细胞百分比、MIP-2、降钙素原(PCT)高于对照组(P<0.05);血清MIP-2、miR-21、miR-129水平联合预测老年心力衰竭患者肺部感染的曲线下面积(AUC)值均高于三者单独预测(P<0.05),血清miR-129及联合预测老年心力衰竭患者肺部感染的敏感度高于血清MIP-2、miR-21(P<0.05),血清MIP-2、miR-21及联合预测老年心力衰竭患者肺部感染的特异度高于血清miR-129(P<0.05).结论老年心力衰竭患者肺部感染的影响因素与年龄、合并糖尿病、侵入性操作、外周血免疫细胞及血清因子水平有关,临床可据此对有以上特征的老年心力衰竭患者进行针对性干预或治疗,降低患者肺部感染发生的风险,同时,血清MIP-2、miR-21、miR-129联合对老年心力衰竭患者肺部感染具有较好的预测价值,因此临床可采用血清MIP-2、miR-21、miR-129对患者发生肺部感染的风险进行预测.OBJECTIVE To investigate the risk factors for pulmonary infection in elderly patients with heart failure and the predictive value of macrophage inflammatory protein-2(MIP-2),microronuclidene-21(miR-21)and microronuclidene-129(miR-129).METHODS The clinical data of 229 elderly patients with heart failure admitted to Huanggang Central Hospital of Dabieshan Regional Medical Center of Hubei Province from Jan.2020 to Jul.2022 were retrospectively collected,and the patients were divided into the infected group(n=103)and the uninfected group(n=126)according to whether they had pulmonary infection,and the risk factors for pulmonary infection in elderly patients with heart failure were summarized,and the predictive value of serum MIP-2,miR-21 and miR-129 on pulmonary infection in elderly patients with heart failure was analyzed by receiver operating characteristic(ROC)curve.RESULTS Age,combined diabetes mellitus,invasive procedures,miR-21,miR-129 were risk factors for pulmonary infection in elderly patients with heart failure(P<o.05).White blood cell count,neutrophil percentage,lymphocyte percentage,MIP-2,procalcitonin(PCT)of the infection group were higher than that of the control group(P<o.05).The area under the curve(AUC)value of combined prediction of serum MIP-2,miR-21 and miR-129 in elderly patients with heart failure was higher than that of all three alone(P<0.05).The sensitivity of serum miR-129 and combined prediction of lung infection in elderly heart failure patients was higher than that of serum MIP-2 and miR-21(P<0.05),and the specificity of serum MIP-2,miR-21 and combined prediction of lung infection in elderly heart failure patients was higher than that of serum miR-129(P<0.05).CONCLUSION The factors affecting pulmonary infection in elderly patients with heart failure were related to age,diabetes mellitus,invasive operations,levels of peripheral blood immune cells and serum factor,according to which,clinical interventions or treatments could be targeted to elderly heart failure patients with the above charac

关 键 词：老年 心力衰竭 肺部感染 危险因素 巨噬细胞炎性蛋白-2 微小核糖核酸-21 微小核糖核酸-129 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]