摘要
目的探讨黏病毒抵抗蛋白A(MXA)、Toll样受体2(TLR2)、血管内皮细胞钙黏蛋白(VE-cadherin)与重症监护室(ICU)机械通气患者肺部感染的关系及病原菌属鉴别效能。方法选取2018年1月-2020年4月河南大学第一附属医院收治的74例ICU机械通气肺部感染患者(研究组)、74例ICU机械通气无肺部感染者(对照A组)及74名健康体检者(对照B组),比较3组MXA蛋白、TLR2 mRNA、VE-cadherin,采用Pearson分析各指标之间及与临床肺部感染(CPIS)评分的相关性,采用Logistic回归方程分析ICU机械通气患者肺部感染影响因素,采用受试者工作特征曲线(ROC)及ROC下面积(AUC)分析各指标诊断ICU机械通气患者肺部感染及鉴别病原菌属的价值。结果 MXA蛋白平均荧光强度与TLR2 mRNA、VE-cadherin呈正相关,MXA蛋白荧光阳性细胞率与TLR2 mRNA、VE-cadherin呈正相关,TLR2 mRNA与VE-cadherin呈正相关(P<0.001)。MXA蛋白平均荧光强度和荧光阳性细胞率、TLR2 mRNA、VE-cadherin均与ICU机械通气患者肺部感染具有相关性(P<0.001)。MXA蛋白平均荧光强度和荧光阳性细胞率、TLR2 mRNA、VE-cadherin均与CPIS评分呈正相关(P<0.001)。MXA蛋白平均荧光强度和荧光阳性细胞率、TLR2 mRNA、VE-cadherin联合诊断ICU机械通气肺部感染的AUC最大,为0.903。VE-cadherin鉴别ICU机械通气患者肺部细菌感染的AUC最大;MXA蛋白荧光阳性细胞率鉴别机械通气患者肺部病毒感染、真菌感染的AUC最大。结论 MXA蛋白平均荧光强度和荧光阳性细胞率、TLR2、VE-cadherin与ICU机械通气肺部感染存在良好线性关系,早期检测上述水平可为ICU机械通气肺部感染诊治、病原菌属鉴别提供新途径。
OBJECTIVE To investigate the relationship between myxovirus resistance protein A(MXA),Toll-like receptor 2(TLR2),vascular endothelial cell cadherin(VE-cadherin)and pulmonary infection in patients with mechanical ventilation in the intensive care unit(ICU)and the efficacy of identifying pathogens.METHODS From Jan.2018 to Apr.2020,a total of 74 mechanically ventilated patients with pulmonary infection in ICU admitted to the First Affiliated Hospital of Henan University(study group),74 mechanically ventilated patients without pulmonary infection in ICU(control group A)and 74 healthy subjects(control group B)were selected.The MXA protein,TLR2 mRNA,and VE-cadherin of the three groups were compared,and Pearson was used to analyze the correlation between the indicators and the clinical pulmonary infection(CPIS)score.Logistic regression equation was used to analyze the influencing factors of pulmonary infection in ICU mechanically ventilated patients,and receiver operating characteristic curve(ROC)and area under ROC(AUC)were used to analyze the value of each index in the diagnosis of pulmonary infection and the identification of pathogenic bacteria in mechanically ventilated patients in ICU.RESULTS The average fluorescence intensity of MXA protein was positively correlated with TLR2 mRNA and VE-cadherin.The rate of MXA protein fluorescence-positive cell was positively correlated with TLR2 mRNA and VE-cadherin,and TLR2 mRNA was positively correlated with VE-cadherin(P<0.001).The average fluorescence intensity of MXA protein,the rate of fluorescence positive cells,TLR2 mRNA,and VE-cadherin were significantly correlated with pulmonary infection of patients with mechanically ventilated in ICU(P<0.001).The average fluorescence intensity of MXA protein,the rate of fluorescence positive cells,TLR2 mRNA,and VE-cadherin were all positively correlated with CPIS score(P<0.001).The AUC of MXA protein combined with the mean fluorescence intensity and positive cell rate of fluorescence,TLR2 mRNA and VE-cadherin in the diagnosis of pul
作者
吴华平
刘洋
洪萌
李权达
谢艳艳
WU Hua-ping;LIU Yang;HONG Meng;LI Quan-da;XIE Yan-yan(Jiangsu Medical Vocational College,Yancheng,Jiangsu224400,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第11期1623-1628,共6页
Chinese Journal of Nosocomiology
基金
江苏省示范性高等职业院校建设基金资助项目(SJG201519SFX01)。
关键词
黏病毒抵抗蛋白A
Toll样受体2
血管内皮细胞钙黏蛋白
重症监护室
机械通气
肺部感染
病原菌属
Myxovirus resistance protein A
Toll-like receptor 2
Vascular endothelial cell cadherin
Intensive care unit
Mechanical ventilation
Pulmonary infection
Pathogenic bacteria
