MDRO肺炎感染患者SAA、PCT、Treg细胞及有关因子表达水平  

Expression Levels of SAA,PCT,Treg Cells and Related Factors in Patients with MDRO Pneumonia Infection

作　　者：张长城 王少芳[1] 李红燕[1] 贾民勇 ZHANG Changcheng;WANG Shaofang;LI Hongyan;JIA Minyong(Department of Respiratory and Critical Care Medicine,Anyang People’s Hospital,Anyang Henan 455000,China)

机构地区：[1]安阳市人民医院呼吸与危重症医学科,河南安阳455000

出　　处：《河南医学高等专科学校学报》2024年第2期168-172,共5页Journal of Henan Medical College

摘　　要：目的探讨血清淀粉样蛋白A(serum amyloid A protein,SAA)、降钙素原(procalcitonin,PCT)、Treg细胞及有关因子在多重耐药菌(multidrug-resisitant organism,MDRO)肺炎感染患者中的表达水平及其与疗效的关联性。方法选取97例MDRO肺炎感染患者为研究对象,根据治疗14 d后的治疗效果分为有效组(73例)和无效组(24例),根据入院时肺炎严重指数(PSI)分为低危(34例)、中危(49例)、高危(14例)三个亚组。比较2组治疗前、治疗7 d后、治疗14 d后SAA、PCT、Treg细胞、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平,比较治疗前低危、中危、高危患者血清各指标水平及PSI评分,分析血清各指标水平与PSI评分的相关性。结果与无效组比较,治疗7、14 d后有效组SAA、PCT、hs-CRP、TNF-α水平较低,Treg细胞数较高,差异有统计学意义(P<0.05);治疗前,低危患者SAA、PCT、hs-CRP、TNF-α及PSI评分<中危患者<高危患者,Treg细胞数>中危患者>高危患者,差异有统计学意义(P<0.05);治疗前,SAA、PCT、hs-CRP、TNF-α水平与PSI评分呈正相关,Treg细胞数与PSI评分呈负相关(P<0.05);受试者操作特征(ROC)曲线显示治疗前SAA、PCT、Treg细胞、hs-CRP、TNF-α联合预测治疗无效的AUC大于各指标单独预测。结论MDRO肺炎感染患者SAA、PCT、hs-CRP、TNF-α、Treg细胞数量呈异常表达,且表达水平对预后具有重要影响,临床可监测其水平变化,联合预测预后的价值较高。Objective To investigate the expression levels of serum amyloid A protein(SAA),procalcitonin(PCT),Treg cells and related factors in patients with multidrug-resistant organism(MDRO)pneumonia infection and the related correlation with efficacy.Methods Ninety-seven patients with MDRO pneumonia infection were selected for the study and were divided into an effective group(73 patients)and an ineffective group(24 patients)based on the therapeutic efficacy after 14 d of treatment.All patients were categorized into three subgroups based on the pneumonia severity index(PSI)at the time of admission:low-risk(34 patients),intermediate-risk(49 patients)and high-risk(14 patients)group.In this study,the levels of SAA,PCT,Treg cells,ultrasensitive C-reactive protein(hs-CRP)and tumour necrosis factor-α(TNF-α)were compared between the two groups before treatment and after 7 d and 14 d of treatment.At the same time,the serum index levels and PSI scores of low-risk,intermediate-risk and high-risk patients were compared before and after treatment,and the related correlation of above-mentioned indicators was analyzed.Results Compared with the ineffective group,SAA,PCT,hs-CRP and TNF-αlevels were lower and Treg cell count was higher in the effective group after 7 and 14 d of treatment(P<0.05).Before treatment,SAA,PCT,hs-CRP,TNF-αlevels and PSI scores gradually increased in low-,intermediate-and high-risk patients;while Treg cell counts gradually decreased,with statistically significant differences(P<0.05).Before treatment,the levels of SAA,PCT,hs-CRP,and TNF-αwere positively correlated with the PSI score,and the number of Treg cells was negatively correlated with the PSI score(P<0.05).Subject operating characteristic(ROC)curves showed that the AUC of combining SAA,PCT,Treg cells,hs-CRP and TNF-αto predict treatment inefficacy was greater than each individual indicator.Conclusion SAA,PCT,hs-CRP,TNF-αand Treg cell counts can be abnormally expressed in patients with MDRO pneumonia infection,and the expression levels have an importa

关 键 词：MDRO肺炎感染 疗效 相关性 SAA PCT TREG细胞 

分 类 号：R446.5[医药卫生—诊断学]