冠心病合并肺部感染患者血清Cys C、MIP-1α水平变化及临床意义  

Changes and clinical significance of serum Cys C and MIP-1αlevels in patients with coronary heart disease combined with pulmonary infection

作　　者：李芸 马育鹏 LI Yun;MA Yupeng(Department of Cardiology,Tianshui Hospital of Traditional Chinese Medicine,Gansu Province,Tianshui 741000,Gansu,China)

机构地区：[1]甘肃省天水市中医院心血管二科,甘肃天水741000

出　　处：《中国病原生物学杂志》2024年第9期1083-1087,共5页Journal of Pathogen Biology

摘　　要：目的探讨冠心病(CHD)合并肺部感染(PI)患者血清胱抑素C(Cys C)、血清巨噬细胞炎性蛋白-1α(MIP-1α)水平变化及临床意义。方法选取2021年1月~2024年1月在本院接受治疗的95例CHD合并PI患者;依据患者的PI病情将其分为:轻度组(49例)、中度组(25例)、重度组(21例);选择CHD未合并PI者95例作为对照组;采用酶联免疫吸附法检测血清Cys C、MIP-1α水平;采用Logistic回归分析CHD患者合并PI的影响因素;受试者工作特征(ROC)曲线分析血清Cys C、MIP-1α水平对CHD合并PI的诊断价值。结果观察组Cys C、MIP-1α、心功能Ⅲ级占比、NT-proBNP、CRP、PCT、WBC显著高于对照组(P<0.05),LVEF显著低于对照组(P<0.05);随CHD合并PI患者病情严重程度增加,血清Cys C、MIP-1α水平逐渐升高(P<0.05);Cys C、MIP-1α是CHD患者合并PI的危险因素(P<0.05);血清Cys C、MIP-1α诊断CHD合并PI的AUC为0.751、0.774,截断值分别为2.77 mg/L、418.55 ng/L,联合诊断的AUC为0.866,二者联合优于血清Cys C、MIP-1α各自单独诊断(Z_(二者联合-Cys C)=3.052、Z_(二者联合-MIP-1α)=2.433,P=0.002、P=0.015)。结论CHD合并PI患者血清Cys C、MIP-1α水平均明显上升,是CHD患者合并PI的危险因素,二者联合对CHD合并PI具有较高的诊断价值。Objective To explore the changes and clinical significance of serum cystatin C(Cys C)and serum macrophage inflammatory protein-1α(MIP-1α)levels in patients with coronary heart disease(CHD)complicated with pulmonary infection(PI).Methods Ninety-five patients with CHD complicated with PI who received treatment in our hospital were selected from January 2021 to January 2024;according to PI condition,they were separated into mild group(49 cases),moderate group(25 cases),and severe group(21 cases);95 cases of CHD without concomitant PI were regarded as the reference group.Enzyme linked immunosorbent assay was applied to detect serum Cys C and MIP-1αlevels.Logistic regression was applied to analyze the influencing factors of combined PI in CHD patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum Cys C and MIP-1αlevels for CHD combined with PI.Results The Cys C,MIP-1α,proportion of grade III heart function,NT-proBNP,CRP,PCT,and WBC in the observation group were obviously higher than those in the reference group(P<0.05),while LVEF was obviously lower than that in the reference group(P<0.05).As the severity of CHD combined with PI increased,serum levels of Cys C and MIP-1αgradually increased(P<0.05).Cys C and MIP-1αwere risk factors for combined PI in CHD patients(P<0.05).The AUC of serum Cys C and MIP-1αin the diagnosis of CHD combined with PI was 0.751 and 0.774,with cutoff value of 2.77 mg/L and 418.55 ng/L,respectively,the AUC of combined diagnosis was 0.866.The combination of the two was superior to the individual diagnosis of serum Cys C and MIP-1α(Z_(combination-Cys C)=3.052,Z_(combination-MIP-1α)=2.433,P=0.002,P=0.015).Conclusion The serum levels of Cys C and MIP-1αin patients with CHD combined with PI have obviously increased,which are risk factors for CHD combined with PI.The combination of the two has high diagnostic value for CHD combined with PI.

关 键 词：冠心病 肺部感染 胱抑素C 巨噬细胞炎性蛋白-1Α 

分 类 号：R541.4[医药卫生—心血管疾病] R563.1[医药卫生—内科学]