急性左心衰并发肺部感染病原学及miR-221、TLR4 mRNA、NF-κB mRNA水平  

Etiology and miR-221,TLR4 mRNA,NF-κB mRNA levels in acute left heart failure complicated with pulmonary infection

作　　者：林长葵 陈瑞娟 钟赞蕊 麦川 LIN Changkui;CHEN Ruijuan;ZHONG Zanrui;MAI Chuan(Haikou People's Hospital(Haikou Hospital,Xiangya Medical College,Central South University),Haikou,Hainan 570208,China;不详)

机构地区：[1]海口市人民医院(中南大学湘雅医学院附属海口医院)急诊科,海南海口570208 [2]海口市人民医院(中南大学湘雅医学院附属海口医院)心血管内科,海南海口570208 [3]海口市第三人民医院急诊科,海南海口571199

出　　处：《中华医院感染学杂志》2025年第4期485-489,共5页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金青年基金资助项目(822QN499)。

摘　　要：目的探讨急性左心衰患者并发肺部感染病原学及微小核糖核酸-221(miR-221)、Toll样受体4(TLR4)mRNA和核因子-κB(NF-κB)mRNA,并分析各指标对预后的预测价值。方法选取2021年6月-2023年6月于海口市人民医院就诊的120例急性左心衰并发肺部感染患者作为感染组,选取同期于医院就诊治疗的120例急性左心衰患者作为未感染组,另选取同期于医院体检的120例健康志愿者作为健康组。对感染组进行为期6个月的随访,根据预后分为预后良好组和预后不良组。统计急性左心衰并发肺部感染患者的病原菌,比较研究对象miR-221、TLR4 mRNA、NF-κB mRNA表达水平。采用受试者工作特征(ROC)曲线分析miR-221、TLR4 mRNA、NF-κB mRNA水平对急性左心衰并发肺部感染患者预后的预测价值。结果120例急性左心衰竭合并肺部感染患者的痰标本,共培养分离病原菌93株,其中革兰阴性菌62株占67.67%,革兰阳性菌25株占26.88%,真菌6株占6.45%,以肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和金黄色葡萄球菌为主。感染组miR-221、TLR4 mRNA、NF-κB mRNA分别为(9.12±2.27)、(1.77±0.64)、(1.55±0.52)高于未感染组和健康组(P<0.05),未感染组高于健康组;预后良好组miR-221、TLR4 mRNA、NF-κB mRNA分别为(8.62±1.79)、(1.52±0.56)、(1.37±0.45)低于预后不良组(P<0.05);miR-221、TLR4 mRNA、NF-κB mRNA水平联合检测预测急性左心衰并发肺部感染患者预后的AUC为0.921高于单独检测(P<0.05)。结论急性左心衰并发肺部感染主要由革兰阴性菌引起,miR-221、TLR4 mRNA、NF-κB mRNA在急性左心衰并发肺部感染患者中呈异常表达,三者联合检测可用于预测急性左心衰并发肺部感染患者预后。OBJECTIVE To investigate the etiology and microRNA-221(miR-221),Toll-like receptor 4(TLR4)and nuclear factor-κB(NF-κB)mRNA in acute left heart failure complicated with pulmonary infections,and to an-alyze their predictive values.METHODS Totally 120 patients with acute left heart failure and pulmonary infection treated in Haikou People's Hospital from Jun.2021 to Jun.2023 were selected as the infection group,which was further divided into good prognostic group and poor prognostic group based on the outcomes of 6-month follow-up,and 120 patients with acute left heart failure and 120 healthy volunteers who underwent physical examination during the same period were selected as the non-infection and the healthy group,respectively.The characteristics of pathogenic bacteria were tested,and the expression levels of miR-221,TLR4 and NF-κB mRNA were com-pared.The receiver operating characteristic(ROC)curve was used to analyze the predictive values of miR-221,TLR4 mRNA and NF-κB mRNA for acute left heart failure complicated with pulmonary infection.RESULTS A to-tal of 93 strains of pathogenic bacteria were isolated from the infection group,of which 62 strains(67.67%)were gram-negative,25 strains(26.88%)were gram-positive,and 6 strains(6.45%)were fungi.Klebsiella pneu-moniae,Pseudomonas aeruginosa,Acinetobacter baumannii and Staphylococcus aureus are responsible for the majority of infected cases.The levels of miR-221,TLR4 mRNA and NF-κB mRNA in the infection group were(9.12±2.27),(1.77±0.64)and(1.55±0.52),respectively,which were higher than those in the un-infection group and the healthy group(P<o.05),and those levels in the un-infection group was higher than those the healthy group;the levels of miR-221,TLR4 mRNA and NF-κB mRNA in the good prognostic group were(8.62±1.79),(1.52±0.56)and(1.37±0.45),respectively,which were lower than those in the poor prog-nostic group(P<0.05).The area under the curve(AUC)of the combined detection of miR-221,TLR4 mRNA and NF-κB mRNA in predicting the prognosis of acute left hear

关 键 词：急性左心衰 肺部感染 微小核糖核酸-221 Toll样受体4 核因子-ΚB 预测价值 

分 类 号：R563.1[医药卫生—呼吸系统]