血清sCD163、CK18、25-(OH)D_(3)对肝硬化食管静脉曲张破裂出血患者医院感染风险的影响及预测价值  

Effect and Predictive Value of Serum sCD163, CK18,25- (OH) D_(3) on the Risk of Nosocomial Infection in Cirrhosis Patients with Esophageal Variceal Bleeding

作　　者：孙孟 王凤超 贾静 刘义锋[3] 王改存 俞致贤[1] SUN Meng;WANG Fengchao;JIA Jing;LIU Yifeng;WANG Gaicun;YU Zhixian(Department of Infectious Disease,Nanyang Central Hospital,Nanyang 471003,China;Department of Cardiovascular Diseases,Nanyang Central Hospital,Nanyang 471003,China;Department of Neurology,Nanyang Central Hospital,Nanyang 471003,China)

机构地区：[1]南阳市中心医院感染性疾病科,河南南阳471003 [2]南阳市中心医院心血管内科,河南南阳471003 [3]南阳市中心医院神经内科,河南南阳471003

出　　处：《河南医学研究》2024年第3期481-484,共4页Henan Medical Research

摘　　要：目的 探讨血清可溶性血红蛋白清道夫受体-163(sCD163)、细胞角蛋白18(CK18)、25-羟维生素D_(3)[25-(OH)D_(3)]对肝硬化合并食管静脉曲张破裂出血(EVB)患者医院感染风险的影响及预测价值。方法 选取南阳市中心医院2021年2月至2023年2月收治的114例肝硬化合并EVB患者,根据入院10 d内是否发生医院感染分为感染组(36例)和非感染组(78例)。比较两组血清sCD163、CK18、25-(OH)D_(3)水平,分析入院时血清sCD163、CK18、25-(OH)D_(3)水平与发生医院感染的相关性及影响因素,评价入院时血清sCD163、CK18、25-(OH)D_(3)水平联合检测对肝硬化合并EVB患者发生医院感染的预测价值。结果 入院时感染组血清sCD163、CK18水平较非感染组高,25-(OH)D_(3)水平较非感染组低(P<0.05);入院时血清CD163、CK18水平与发生医院感染均呈正相关,25-(OH)D_(3)水平与发生医院感染呈负相关(P<0.05);入院时血清sCD163(>5.16 mg·L^(-1))、CK18(>14.25μg·L^(-1))水平为发生医院感染的危险因素,25-(OH)D_(3)(>8.62μg·L^(-1))水平为发生医院感染的保护因素。入院时血清sCD163、CK18、25-(OH)D_(3)水平联合预测EVB患者发生医院感染的曲线下面积大于各单一指标(P<0.05)。结论 肝硬化合并EVB患者血清sCD163、CK18、25-(OH)D_(3)水平与医院感染有关,是影响医院感染的独立风险因素。Objective To investigate the impact and predictive value of serum soluble hemoglobin scavenger receptor differentiation-163(sCD163),cytokeratin 18(CK18),and 25-hydroxyvitamin D_(3)[25-(OH)D_(3)]on the risk of hospital infection cirrhosis patients with esophageal variceal bleeding(EVB).Methods A total of 114 cirrhosis patients with EVB admitted to Nanyang Central Hospital from February 2021 to February 2023 were selected.They were divided into infected group(36 cases)and non-infected group(78 cases)based on whether hospital infection occurred within 10 days of admission.The serum levels of sCD163,CK18,and 25-(OH)D_(3) were compared between two groups,the correlation and influencing factors between serum sCD163,CK18,and 25-(OH)D_(3) levels at admission for the nosocomial infection were analyzed,and the predictive value of combined detection of serum sCD163,CK18,and 25-(OH)D_(3) levels at admission for the nosocomial infection in cirrhosis patients with EVB was evaluated.Results At admission,the serum levels of sCD163 and CK18 in the infected group were higher than those in the non-infected group,while the level of 25-(OH)D_(3) was lower than the non-infected group(P<0.05).The levels of serum CD163 and CK18 at admission were positively correlated with the nosocomial infection,while the level of 25-(OH)D_(3) was negatively correlated with the nosocomial infection(P<0.05).The serum sCD163(>5.16 mg·L^(-1))and CK18(>14.25μg·L^(-1))levels on admission were risk factors for nosocomial infection,and 25-(OH)D_(3)(>8.62μg·L^(-1))level was protective factors for nosocomial infection.The area under curve of serum sCD163,CK18,25-(OH)D_(3) combined to predict nosocomial infection in patients with EVB was higher than that of each single index(P<0.05).Conclusion The serum levels of sCD163,CK18 and 25-(OH)D_(3) in cirrhosis patients with EVB are associated with nosocomial infection and are independent risk factors for nosocomial infection.

关 键 词：肝硬化 食管静脉曲张破裂出血 医院感染 可溶性血红蛋白清道夫受体-163 细胞角蛋白18 25-羟维生素D_(3) 

分 类 号：R575.2[医药卫生—消化系统]