外周血miR-21、MIP-2、PCT及IL-6在冠心病慢性心力衰竭合并肺部感染患者中的表达及意义  

Expression and significance of miR-21,MIP-2,PCT and IL-6 in peripheral blood in pa-tients with coronary heart disease and chronic heart failure complicated with pulmonary infection

作　　者：王建爱 于蕾[2] 罗育红[1] 张晖[1] 胡建秀[1] WANG Jianai;YU Lei;LUO Yuhong;ZHANG Hui;HU Jianxiu(Department of Critical Care Medicine,Qinhuangdao Second Hospital,Qinhuangdao,Hebei,China,066600;Emergency Care Unit of Qinhuangdao Second Hospital,Qinhuangdao,Hebei,China,066600)

机构地区：[1]秦皇岛市第二医院重症医学科,河北秦皇岛066600 [2]秦皇岛市第二医院急诊监护室,河北秦皇岛066600

出　　处：《分子诊断与治疗杂志》2023年第12期2167-2171,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生厅科研基金项目(20221361)。

摘　　要：目的分析外周血microRNA-21(miR-21)、巨噬细胞炎性蛋白-2(MIP-2)、降钙素原(PCT)及白介素-6(IL-6)在冠心病慢性心力衰竭(CHF)合并肺部感染(PI)患者中的表达及意义。方法选取2020年2月至2023年3月秦皇岛市第二医院收治的冠心病慢性心力衰竭患者121例为研究对象,根据是否发生PI分为CHF合并PI组37例与CHF无PI组84例。比较两组一般资料及外周血miR-21、MIP-2、PCT及IL-6水平,采用Logistic分析影响冠心病慢性心力衰竭合并肺部感染发生的危险因素;采用Pearson相关性分析外周血miR-21、MIP-2、PCT及IL-6水平与临床肺部感染评分(CPIS)、序贯器官衰竭评分(SOFA)的相关性;分析CHF合并PI组病原菌情况,对比不同病原菌外周血miR-21、MIP-2、PCT及IL-6水平。结果两组性别、年龄、CHF病程、吸烟史、饮酒史、中性粒细胞百分比、肌酸激酶、心肌型肌酸激酶同工酶比较,差异无统计学意义(P>0.05);两组白细胞计数、CPIS、SOFA评分、miR-21、MIP-2、PCT及IL-6水平比较,差异具有统计学意义(P<0.05)。多元Logistic回归分析结果显示,白细胞计数、CPIS、SOFA评分、miR-21、MIP-2、PCT及IL-6水平升高均是影响冠心病CHF合并PI发生的危险因素(P<0.05)。miR-21、MIP-2、PCT及IL-6水平均与CPIS、SOFA评分呈正相关(P<0.05)。37例CHF合并PI患者痰液标本检出48株病原菌,其中34株革兰阴性菌,12株革兰阳性菌,2株真菌。miR-21、MIP-2、PCT及IL-6水平:革兰阴性菌>革兰阳性菌>真菌,差异有统计学意义(P<0.05)。结论miR-21、MIP-2、PCT及IL-6水平在冠心病CHF合并PI患者中呈上升趋势,且与PI病情程度、病原菌类型相关,早期检测miR-21、MIP-2、PCT及IL-6水平对于冠心病CHF合并PI患者的诊断、病情及鉴别病原菌类型具有重要价值。Objective To analyze the expression and significance of microRNA-21(miR-21),macrophage inflammatory protein-2(MIP-2),procalcitonin(PCT)and interleukin-6(IL-6)in peripheral blood in patients with coronary heart disease and chronic heart failure(CHF)complicated with pulmonary infection(PI).Methods 121 patients with coronary heart disease and chronic heart failure admitted to the Second Hospital of Qinhuangdao City from February 2020 to March 2023 were selected as the study objects and were divided into the CHF group with PI of 37 cases and the CHF group without PI of 84 cases according to whether PI occurred.General data and levels of miR-21,MIP-2,PCT and IL-6 in peripheral blood were compared between the two groups,Multivariate logistic analysis was used to analyze the risk factors affecting the occurrence of CHD chronic heart failure with pulmonary infection.Pearson correlation was used to analyze the correlation of miR-21,MIP-2,PCT and IL-6 levels in peripheral blood with clinical pulmonary infection score(CPIS)and sequential organ failure score(SOFA);the pathogenic bacteria in CHF combined with PI group were analyzed,the levels of miR-21,MIP-2,PCT and IL-6 in peripheral blood of different pathogenic bacteria were compared.Results There was no significant difference in gender,age,CHF course,smoking history,drinking history,neutrophil percentage,creatine kinase and myocardial creatine kinase isoenzyme between the two groups(P>0.05).There were statistically significant differences in WBC count,CPIS,SOFA score,miR-21,MIP-2,PCT and IL-6 levels between the two groups(P<0.05).Multiple logistic regression analysis showed that the increase of leukocyte count,CPIS,SOFA score,miR-21,MIP-2,PCT and IL-6 levels were risk factors for the occurrence of coronary heart disease CHF combined with PI in CHD(P<0.05).The levels of miR-21,MIP-2,PCT and IL-6 were positively correlated with CPIS and SOFA scores(P<0.05).48 strains of pathogenic bacteria were detected in sputum samples of 37 CHF patients with PI,including 34 gram-negative

关 键 词：MIR-21 MIP-2 PCT IL-6 慢性心力衰 肺部感染 

分 类 号：R541[医药卫生—心血管疾病] R563.1[医药卫生—内科学]