老年心力衰竭合并肺部感染患者病原菌分布及血清IL-8、PTX3水平变化  

Distribution of pathogenic bacteria and changes in serum IL-8 and PTX3 levels in elderly patients with heart failure combined with pulmonary infection

作　　者：杨海燕 刘英 曹艳华 黄燕红 YANG Haiyan;LIU Ying;CAO Yanhua;HUANG Yanhong(Shanghai Pudong Hospital(Pudong Hospital Affiliated to Fudan University),Shanghai 201399,China)

机构地区：[1]上海市浦东医院(复旦大学附属浦东医院),上海201399

出　　处：《中国病原生物学杂志》2024年第6期724-728,共5页Journal of Pathogen Biology

基　　金：(ShanghaiPudongHospital(PudongHosp)tal Affiliated to Fudan University)。

摘　　要：目的探讨老年心力衰竭合并肺部感染患者病原菌分布及血清白介素-8(IL-8)、正五聚蛋白3(PTX3)水平变化。方法回顾性收集本院2022年11月-2023年12月接诊的120例心力衰竭合并肺部感染老年患者作为观察组,收集同期本院体检健康者132例作为对照组,采用ELISA试剂盒检测血清IL-8、PTX3水平;患者治疗前收集呼吸道分泌物标本,培养病原体并进行药敏试验;根据患者的预后分为生存组(n=105)和死亡组(n=15),Logistic分析患者预后的影响因素;绘制ROC曲线分析血清IL-8、PTX3水平对老年心力衰竭合并肺部感染患者预后的诊断价值。结果患者的呼吸道分泌物标本培养病原菌共112株,其中革兰阳性菌26株(23.21%),革兰阴性菌76株(67.86%),真菌10株(8.93%);观察组较对照组血清IL-8[(13.22±2.07)ng/L vs(7.42±1.42)ng/L]、PTX3水平[(11.36±1.44)ng/L vs(6.25±1.03)ng/L]均升高(P<0.05);死亡组较生存组血清IL-8[(19.34±2.34)ng/L vs(12.35±2.03)ng/L]、PTX3水平[(18.34±2.03)ng/L vs(10.36±1.36)ng/L]均升高(P<0.05);Logistic回归分析得知PIL-8、PTX3是患者预后的危险因素(P<0.05)。血清IL-8、PTX3单独及联合诊断患者发生死亡的AUC分别为0.819、0.792、0.866,二者联合诊断的AUC高于单独诊断(Z=2.068、2.013,P=0.024、0.026)。结论老年心力衰竭合并肺部感染患者血清IL-8、PTX3水平显著升高,感染病原菌以革兰阴性菌为主,IL-8、PTX3过表达可能增加死亡风险,定期监测血清IL-8、PTX3水平变化可能对减少预后不良的发生有积极作用。Objective To investigate the distribution of pathogens and changes in serum levels of interleukin-8(IL-8)and pentraxin-3(PTX3)in elderly patients with heart failure complicated by pulmonary infection.Methods A retrospective collection of 120 elderly patients with heart failure combined with pulmonary infection seen in our hospital from November 2022 to December 2023 was used as an observation group,and 132 healthy individuals who underwent physical examinations at our hospital were as the control group.ELISA kit was applied to detect serum IL-8 and PTX3 levels.Respiratory secretion samples were collected from patients before treatment,the pathogen was cultured and drug sensitivity tests were conducted.According to the patient's prognosis,they were separated into survival group(n=105)and death group(n=15).Logistic analysis of factors affecting patients'prognosis;drawing ROC curves to analyse the diagnostic value of serum IL-8 and PTX3 levels on the prognosis of elderly patients with heart failure combined with pulmonary infection.Results The patient's respiratory secretion specimens were cultured for a total of 112 pathogenic bacteria,of which 26(23.21%)were Gram-positive,76(67.86%)Gram-negative,and 10(8.93%)were fungi.The serum levels of IL-8[(13.22±2.07)ng/L vs(7.42±1.42)ng/L]and PTX3[(11.36±1.44)ng/L vs(6.25±1.03)ng/L]in the monitored group were higher than those in the control group(P<0.05).The serum IL-8[(19.34±2.34)ng/L vs(12.35±2.03)ng/L]and PTX3 levels[(18.34±2.03)ng/L vs(10.36±1.36)ng/L]in the death group were higher than those in the survival group(P<0.05).Logistic regression analysis informed that PIL-8 and PTX3 were risk factors for patients'prognosis(P<0.05).The AUCs for death occurring in patients with serum IL-8 and PTX3 diagnosis alone and in combination were 0.819,0.792,and 0.866,respectively,respectively,and the AUC of the combination of the two was higher than that of the diagnosis alone(Z=2.068,2.013,P=0.024,0.026).Conclusion Serum IL-8 and PTX3 levels are significantly elevated in elde

关 键 词：老年心力衰竭合并肺部感染 病原菌 白介素-8 正五聚蛋白3 预后 

分 类 号：R541.6[医药卫生—心血管疾病] R563.1[医药卫生—内科学]