急性脑卒中合并肺部感染患者血清TNFSF14、Periostin、sFLt-1的表达及其与预后的关系  

Changes in serum TNFSF14,Periostin,sFLt-1 expression and their relationship with infection prognosis in patients with acute stroke complicated with pulmonary infection

作　　者：黄建平 姜琴琴 胡嘉琪 HUANG Jianping;JIANG Qinqin;HU Jiaqi(Department of Infection,Jianli People's Hospital,Jianli Hubei 433300,China)

机构地区：[1]监利市人民医院感染科,湖北监利433300

出　　处：《中国急救复苏与灾害医学杂志》2025年第3期375-378,392,共5页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探究急性脑卒中(AS)合并肺部感染患者血清肿瘤坏死因子超家族成员14(TNFSF14)、骨膜蛋白(Periostin)、可溶性fms样酪氨酸激酶-1(sFLt-1)表达变化及其与感染预后的关系。方法选择2020年6月—2022年10月监利市人民医院收治的AS患者126例,根据入院后48 h内是否发生肺部感染分为感染组(n=45)和未感染组(n=81)。采用ELISA法检测血清TNFSF14、Periostin、sFLt-1水平。Pearson相关性分析探究血清TNFSF14、Periostin、sFLt-1水平与AS合并肺部感染的相关性;多因素Logistic回归分析影响AS合并肺部感染患者预后的因素;ROC曲线评估血清TNFSF14、Periostin、sFLt-1对AS合并肺部感染患者预后的预测价值。结果感染组血清TNFSF14、Periostin、sFLt-1水平均高于未感染组(t=26.944、10.120、22.266,P<0.05)。预后不良组血清TNFSF14、Periostin、sFLt-1水平均高于预后良好组(t=5.292、3.845、4.733,P<0.05)。预后不良组WBC、TNF-α、NIHSS评分、CPIS评分、MRS评分高于预后良好组(t=4.698、9.339、8.161、9.613、2.890,P<0.05)。AS合并肺部感染患者血清TNFSF14、Periostin、sFLt-1水平与CPIS评分均呈正相关(r=0.516,0.621,0.534,均P<0.05)。多因素Logistic回归分析显示,WBC、TNF-α、TNFSF14、Periostin、sFLt-1均为影响AS合并肺部感染患者预后不良的危险因素(P<0.05)。ROC曲线显示,TNFSF14、Periostin、sFLt-1预测AS合并肺部感染患者预后的AUC分别为0.768、0.769、0.683,联合预测的AUC为0.891,显著大于三者单独预测的AUC(P<0.05)。结论血清TNFSF14、Periostin、sFLt-1水平在AS合并肺部感染患者中均上升,可作为预后评估的生物标志物。Objective To investigate the expression changes of serum tumor necrosis factor superfamily member 14(TNFSF14),Periostin,and soluble fms-like tyrosine kinase-1(sFLt-1)in patients with acute stroke complicated by pulmonary infection,and their relationship with infection prognosis.Methods A total of 126 AS patients admitted to our hospital from June 2020 to October 2022 were collected.They were separated into two groups based on whether they had developed pulmonary infections within 48 hours after admission.45 patients with pulmonary infections were in the infection group,while 81 patients without pulmonary infections were in the non infection group.Enzyme linked immunosorbent assay was applied to detect serum levels of TNFSF14,Periostin,and sFLt-1.Pearson correlation analysis was conducted to explore the correlation between serum levels of TNFSF14,Periostin,sFLt-1 and AS with pulmonary infection.Logistic regression model was used to analyze the prognostic factors of AS patients with pulmonary infection.ROC curve was applied to evaluate the predictive value of serum TNFSF14,Periostin,and sFLt-1 for the prognosis of patients with AS complicated with pulmonary infection.Results The serum levels of TNFSF14,Periostin,and sFLt-1 in the infection group were higher(P<0.05).The serum levels of TNFSF14,Periostin,and sFLt-1 in the poor prognosis group were higher(P<0.05).The NIHSS score,CPIS score,MRS score,and level of WBC and TNF-α of the poor prognosis group were higher(P<0.05).Serum levels of TNFSF14,Periostin,sFLt-1 were positively correlated with CPIS scores in AS patients with pulmonary infection(r=0.516,0.621,0.534,all P<0.05).Logistic regression model analysis showed that WBC,TNF,TNFSF14,Periostin,and sFLt-1 were factors affecting the poor prognosis of patients with AS complicated with pulmonary infection(P<0.05).ROC shows that the AUC predicted by TNFSF14,Periostin,and sFLt-1 for the prognosis of patients with AS complicated with pulmonary infection was 0.768,0.769,and 0.683,respectively,the AUC predicted by their

关 键 词：急性脑卒中 肺部感染 肿瘤坏死因子超家族成员14 骨膜蛋白 可溶性fms样酪氨酸激酶-1 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]