尿毒症维持性血液透析患者血清HMGB1、NGAL、miR-15a、miR-34b水平与导管相关性感染的关联性  

Correlation between serum HMGB1,NGAL,miR-15a and miR-34b levels and catheter-related infection in uremic maintenance hemodialysis patients

作　　者：钟倩 崔雪曼 李帅 许丹凤 陈忱 ZHONG Qian;CUI Xue-man;LI Shuai;XU Dan-feng;CHEN Chen(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121000,China)

机构地区：[1]锦州医科大学附属第一医院血液透析室,辽宁锦州121000 [2]锦州医科大学附属第一医院传染科,辽宁锦州121000

出　　处：《中华医院感染学杂志》2024年第8期1163-1167,共5页Chinese Journal of Nosocomiology

基　　金：辽宁省科研基金资助项目(2021LK031011)。

摘　　要：目的探讨尿毒症维持性血液透析患者血清高迁移率族蛋白1(HMGB1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)、微小核糖核酸(miR)-15a、miR-34b水平与导管相关性感染发生的关系。方法回顾性选取2020年4月-2023年4月锦州医科大学附属第一医院收治的52例尿毒症维持性血液透析并发导管相关性感染患者(感染组)和54例尿毒症维持性血液透析未并发导管相关性感染患者(未感染组)作为研究对象,统计病原菌特点,比较两组血清HMGB1、NGAL、miR-15a、miR-34b水平,分析血清HMGB1、NGAL、miR-15a、miR-34b水平与尿毒症维持性血液透析患者并发导管相关性感染的关系,采用受试者工作特征(ROC)曲线分析血清HMGB1、NGAL、miR-15a、miR-34b水平单独及联合检测对尿毒症维持性血液透析并发导管相关性感染患者的诊断价值。结果52例尿毒症维持性血液透析并发导管相关性感染患者共培养出病原菌53株,其中革兰阴性菌33株,占62.26%;革兰阳性菌17株,占32.08%;真菌3株,占5.66%;感染组HMGB1、NGAL、miR-34b水平高于未感染组,miR-15a水平低于未感染组(P<0.05);血清HMGB1、NGAL、miR-34b与尿毒症维持性血液透析患者并发导管相关性感染呈正相关(P<0.05),血清miR-15a与尿毒症维持性血液透析患者并发导管相关性感染呈负相关(P<0.05);血清HMGB1、NGAL、miR-15a、miR-34b联合检测对尿毒症维持性血液透析并发导管相关性感染患者的诊断曲线下面积(AUC)值为0.941,敏感度为94.23%,特异度为81.48%。结论尿毒症维持性血液透析并发导管相关性感染患者血清HMGB1、NGAL、miR-34b呈高表达,miR-15a呈低表达,四者与该病具有相关性,且四者联合检测对该病诊断价值较高。OBJECTIVE To investigate the relationship between the levels serum of high mobility group protein 1(HMGB1),neutrophil gelatinase-related apolipoprotein(NGAL),micro ribonucleic acid(miR)-15a and miR-34b and the occurrence of catheter-related infection in uremic maintenance hemodialysis patients.METHODS The clini-cal data of 52 uremic maintenance hemodialysis patients complicated with catheter-related infection(as the infec-tion group)and 54 uremic maintenance hemodialysis patients without catheter-related infection(as the uninfected group)admitted to the First Affiliated Hospital of Jinzhou Medical University from Apr 2020 to Apr 2023 were retrospectively collected as the research objects.The characteristics of pathogens were analyzed.The levels serum of HMGB1,NGAL,miR-15a and miR-34b were compared between the two groups,and the correlations between the above indxes and catheter-related infection in uremic maintenance hemodialysis patients were analyzed.Receiv-er operating characteristic(ROC)curve was used to analyze the diagnostic value of serum HMGB1,NGAL,miR-15a and miR-34b levels on catheter-related infection during maintenance hemodialysis in uremia patients.RESULTS A total of 53 strains of pathogenic bacteria were cultured from the specimens of 52 uremic maintenance hemodialy-sis patients complicated with catheter-related infection,of which 33 strains were gram-negative bacteria,account-ing for 62.26%.There were 17 strains of gram-positive bacteria,accounting for 32.08%and 3 strains of fungi,ac-counting for 5.66%.The serum levels of HMGB1,NGAL and miR-34b in the infection group were higher than those in the uninfection group,and the serum level of miR-15a was lower than that in the uninfection group,with statistical significance(P<0.05).Serum HMGB1,NGAL and miR-34b levels were positively correlated with catheter-related infection in uremic maintenance hemodialysis patients(P<0.05),while serum miR-15a was nega-tively correlated with catheter-related infection(P<0.05).The area under the curve(AUC)value of comb

关 键 词：尿毒症 维持性血液透析 导管相关性血流感染 病原菌 高迁移率族蛋白1 中性粒细胞明胶酶相关载脂蛋白 微小核糖核酸-15a 微小核糖核酸-34b 

分 类 号：R692.5[医药卫生—泌尿科学]