老年患者脑卒中后康复期肺部感染血清MIP-1α、HBD3水平及临床意义  

The levels and clinical significance of serum MIP-1αand HBD3in elderly patients with pulmonary infection during the rehabilitation period after stroke

作　　者：司丽芳 赵莹[2] 刘锋涛 SI Lifang;ZHAO Ying;LIU Fengtao(Rehabilitation Medicine Center,Shengjing Hospital,China Medical University,Shenyang 110000,China;Second Geriatric Medicine Department Internal Medicine General Ward,Shengjing Hospital,China Medical University)

机构地区：[1]中国医科大学附属盛京医院康复医学中心,辽宁沈阳110000 [2]中国医科大学附属盛京医院第二老年医学科内科综合病房

出　　处：《中国病原生物学杂志》2025年第2期239-243,共5页Journal of Pathogen Biology

摘　　要：目的研究脑卒中后康复期肺部感染老年患者的血清巨噬细胞炎症蛋白-1α(MIP-1α)、人β-防御素3(HBD3)的临床意义。方法选取2022年1月至2024年1月期间本院收治的脑卒中后康复期老年患者194例,根据康复期有无发生肺部感染分为感染组(66例)与非感染组(128例)。利用美国国立卫生研究院卒中量表(NIHSS)评估患者入院后的脑卒中程度;收集患者康复期的临床资料;利用ELISA法检测血清MIP-1α、HBD3;采用Spearman分析血清MIP-1α、HBD3与NIHSS、CPIS的相关性;采用Logistic回归分析脑卒中后康复期老年患者肺部感染的影响因素;采用ROC分析血清MIP-1α、HBD3对脑卒中后康复期老年患者肺部感染的预测价值。结果感染组有吞咽困难、气管切开术、侵入性操作、糖尿病史、吸烟史以及住院时间>14d的患者占比高于未感染组,WBC、CRP、NIHSS、CPIS、MIP-1α、HBD3高于未感染组,ALB、PLT低于未感染组(P<0.05)。吞咽困难[OR=3.341(1.175-9.497)]、气管切开术[OR=2.665(1.152-6.166)]、侵入性操作[OR=1.890(1.362-2.622)]、住院时间长[OR=3.872(1.392-10.771)]、高水平CRP[OR=4.073(2.709-6.123)]、MIP-1α[OR=1.455(1.037-2.042)]、HBD3[OR=2.508(1.324-4.751)]是脑卒中后康复期老年患者肺部感染的危险因素(P<0.05)。血清MIP-1α、HBD3与NIHSS(r=0.452、r=0.407)和CPIS(r=0.531、r=0.395)呈正相关(P<0.05)。联合血清MIP-1α、HBD3对脑卒中后康复期老年患者肺部感染的预测AUC(0.925)高于血清MIP-1α、HBD3单独的预测AUC(0.796、0.780)(P<0.05)。结论脑卒中后康复期肺部感染老年患者的血清MIP-1α、HBD3水平较高,MIP-1α、HBD3是脑卒中后康复期老年患者肺部感染的影响因素,联合检测MIP-1α、HBD3或可预测患者的肺部感染。Objective To investigate the clinical significance of serum macrophage inflammatory protein-1α(MIP-1α)and human beta defensin 3(HBD3)in elderly patients with pulmonary infection during the rehabilitation period after stroke.Methods A total of 194elderly stroke patients admitted to our hospital during the rehabilitation period from January 2022to January 2024were collected.They were grouped into an infection group(66cases)and a non infection group(128cases)based on the occurrence of pulmonary infection during the rehabilitation period.The National Institutes of Health Stroke Scale(NIHSS)was used to assess the degree of stroke in patients after admission.Clinical data were collected from patients during rehabilitation period.ELISA method was applied to detect serum MIP-1αand HBD3.Spearman was applied to analyze the correlation between serum MIP-1α,HBD3,NIHSS,and CPIS.Logistic regression was applied to analyze the influencing factors of pulmonary infection in elderly patients during the rehabilitation period after stroke.ROC was applied to analyze the predictive value of serum MIP-1αand HBD3for pulmonary infection in elderly patients during the rehabilitation period after stroke.Results The proportions of patients with dysphagia,tracheotomy,invasive procedures,diabetes history,smoking history and hospitalization time>14days in the infection group were higher than those in the non infection group,the WBC,CRP,NIHSS,CPIS,MIP-1α,HBD3were higher than those in the non infection group,while ALB and PLT were lower than those in the non infection group(P<0.05).Dysphagia[OR=3.341(1.175-9.497)],tracheostomy[OR=2.665(1.152-6.166)],invasive procedures[OR=1.890(1.362-2.622)],long hospital stay[OR=3.872(1.392-10.771)],high levels of CRP[OR=4.073(2.709-6.123)],MIP-1α[OR=1.455(1.037-2.042)],and HBD3[OR=2.508(1.324-4.751)]were risk factors for pulmonary infection in elderly patients during the rehabilitation period after stroke(P<0.05).Serum MIP-1αand HBD3were positively correlated with NIHSS(r=0.452,0.407)and CPIS(r=0.531,0.

关 键 词：老年脑卒中 康复期 肺部感染 巨噬细胞炎症蛋白-1Α 人β-防御素3 

分 类 号：R47[医药卫生—护理学]