血清hBD-2、Periostin、TSP-1水平对急性脑卒中合并肺部感染诊断和预后评估的临床价值分析  

Clinical value analysis of levels of serum hBD-2, Periostin, and TSP-1 in the diagnosis and prognosis evaluation of acute stroke complicated with pulmonary infection

作　　者：李洁 胡彪 李瑞丽 米九运 周志刚 Li Jie;Hu Biao;Li Ruili;Mi Jiuyun;Zhou Zhigang(Department of Respiratory and Critical Care,Xi'an Ninth Hospital,Shaanxi,Xi’an 710054,China)

机构地区：[1]西安市第九医院呼吸与危重症科,710054

出　　处：《疑难病杂志》2025年第4期434-438,444,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：陕西省重点研发计划项目(2018SF-211)。

摘　　要：目的探究血清人β防御素-2(hBD-2)、骨膜蛋白(Periostin)、血小板反应蛋白-1(TSP-1)水平对急性脑卒中(AS)合并肺部感染诊断和预后评估的临床价值。方法选择2021年9月—2023年9月西安市第九医院呼吸与危重症科收治的AS合并肺部感染患者102例作为感染组,另选取同期AS未合并肺部感染患者102例作为未感染组。采用酶联免疫吸附法检测血清hBD-2、Periostin、TSP-1水平;Logistic回归分析AS合并肺部感染的影响因素;采用ROC曲线评估血清hBD-2、Periostin、TSP-1水平对AS合并肺部感染的诊断价值以及对预后的预测价值。结果感染组患者侵入性操作、吞咽障碍比例及血清hBD-2、Periostin、TSP-1水平高于未感染组(χ^(2)/t/P=7.846/0.005、9.730/0.002、10.242/<0.001、4.819/<0.001、12.246/<0.001);预后不良亚组血清hBD-2、Periostin、TSP-1水平均高于预后良好亚组(t/P=4.335/<0.001、6.571/<0.001、5.441/<0.001);侵入性操作、吞咽障碍、血清hBD-2高、Periostin高、TSP-1水平高均为AS合并肺部感染的危险因素[OR(95%CI)=2.839(1.501~5.368)、3.229(1.557~6.695)、4.209(1.886~9.494)、3.823(1.592~9.181)、3.924(1.915~8.040)]。血清hBD-2、Periostin、TSP-1及三者联合预测AS合并肺部感染的AUC分别为0.735、0.782、0.781、0.878,三者联合优于各自单独预测效能(Z/P=2.788/0.005、2.807/0.005、2.049/0.040);血清hBD-2、Periostin、TSP-1及三者联合预测AS合并肺部感染预后的AUC分别为0.790、0.785、0.782、0.861,三者联合预测的AUC与hBD-2、Periostin及TSP-1单独预测的AUC比较差异无统计学意义(Z/P=1.258/0.209、1.580/0.114、1.416/0.157)。结论AS合并肺部感染患者血清hBD-2、Periostin、TSP-1水平较高,与患者预后密切相关,且三者联合诊断AS合并肺部感染的临床价值较高。Objective To investigate the clinical value of serum levels of human beta-defensin-2(hBD-2),Periostin,and thrombospondin-1(TSP-1)in the diagnosis and prognosis evaluation of acute stroke(AS)complicated with pulmonary infection.Methods A total of 102 AS patients with lung infection admitted to the Respiratory and Critical Care Department of Xi'an Ninth Hospital from September 2021 to September 2023 were selected AS the infection group,and another 102 AS patients without lung infection during the same period were selected as the non-infection group.Enzyme linked immunosorbent assay was applied to detect serum levels of hBD-2,Periostin,and TSP-1.ROC curve was applied to evaluate the diagnostic value of serum hBD-2,Periostin,and TSP-1 for AS complicated with pulmonary infection,and their predictive value for prognosis.Logistic regression analysis was applied to analyze the influencing factors of pulmonary infection in AS patients.Results The proportion of patients under went invasive procedures with dysphagia,and the levels of serum hBD-2,Periostin,TSP-1 in the infection group were higher than those in non-infection group(t/P=10.242/<0.001,4.819/<0.001,12.246/<0.001).The levels of serum hBD-2,Periostin and TSP-1 in the poor prognosis subgroup were higher than those in the good prognosis subgroup(t/P=4.335/<0.001,6.571/<0.001,5.441/<0.001).Invasive operation,dysphagia,high hBD-2,high Periostin,and high TSP-1 levels were all influencing factors of AS combined with pulmonary infection[OR(95%CI)=2.839(1.501-5.368),3.229(1.557-6.695).4.209(1.886-9.494),3.823(1.592-9.181),3.924(1.915-8.040)].The AUC of serum hBD-2,Periostin,TSP-1 and their combination in predicting AS with pulmonary infection were 0.735,0.782,0.781,and 0.878,and the AUC of the combined use of the three markers was larger than that of the individual prediction(Z/P=2.788/0.005,2.807/0.005,2.049/0.040).The AUC of serum hBD-2,Periostin,TSP-1,and their combined use in predicting the prognosis of pulmonary infection in AS were 0.790,0.785,0.782,and 0.861,and the

关 键 词：急性脑卒中 肺部感染 人Β防御素-2 骨膜蛋白 血小板反应蛋白-1 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R563[医药卫生—临床医学]