摘要
目的分析慢性心力衰竭(CHF)并发肺部感染患者外周血微小RNA-183(miR-183)、miR-21-3p、miR-146b水平变化及意义。方法选择2019年1-12月河南省胸科医院收治的CHF患者为研究对象。按是否发生肺部感染分为CHF组(n=114)、CHF并发肺部感染组(n=46),另按性别、年龄匹配原则选取同期于医院接受健康体检的健康志愿者30名作为对照组;分析CHF并发肺部感染患者检出病原菌情况,并比较三组外周血miR-183、miR-21-3p、miR-146b水平,比较不同肺部感染严重程度的CHF患者外周血miR-183、miR-21-3p、miR-146b水平;Logistic逐步回归分析外周血miR-183、miR-21-3p、miR-146b与CHF并发肺部感染的关系;绘制受试者工作特征(ROC)曲线分析外周血miR-183、miR-21-3p、miR-146b及平行试验、序列试验对CHF并发肺部感染的预测价值。结果46例CHF并发肺部感染患者共培养分离病原菌79株,主要致病菌为肺炎克雷伯菌(21.52%)、铜绿假单胞菌(17.72%);CHF、CHF并发肺部感染组患者外周血miR-183、miR-21-3p、miR-146b均高于对照组(P<0.05),CHF并发肺部感染组患者外周血miR-183、miR-21-3p、miR-146b均高于CHF组(P<0.05);随着肺部感染病情严重程度增加,CHF并发肺部感染组患者外周血miR-183、miR-21-3p、miR-146b上升(P<0.05);Logistic逐步回归分析显示miR-183、miR-21-3p、miR-146b与白细胞介素-6(IL-6)是CHF患者并发肺部感染的影响因素(P<0.05);miR-146b的曲线下面积值(AUC)高于单一miR-183、miR-21-3p预测及平行试验、序列试验预测(AUC:0.795、0.756、0.626、0.741、0.576),以6.21为miR-146bcut-off,敏感度、特异性分别为52.17%、96.49%。结论外周血miR-183、miR-21-3p、miR-146b在CHF并发肺部患者中呈高表达,且随肺部感染程度加重而上升,miR-146b可作为预测CHF并发肺部感染的特异性指标。
OBJECTIVE To analyze the changes and significance of peripheral blood miR-183,miR-21-3p and miR-146blevels in patients with chronic heart failure(CHF)complicated by pulmonary infection.METHODS The CHF patients admitted to cardiovascular medicine department of Henan Chest Hospital from Jan.to Dec.2019were selected and divided into CHF group(n=114)and CHF complicated with pulmonary infection group(n=46)according to whether they had pulmonary infection.In addition,30healthy volunteers who underwent physical examination in the hospital during the same period were selected as the control group based on the principle of gender and age matching.Pathogens detected in patients with CHF complicated by pulmonary infection were analyzed,and the levels of peripheral blood miR-183,miR-21-3p and miR-146bin patients of the three groups and in CHF patients with different severity of pulmonary infection were compared.Logistic stepwise regression analysis was conducted to analyze the relationship between peripheral blood miR-183,miR-21-3p,miR-146band CHF with pulmonary infection.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of parallel test and sequential test of peripheral blood miR-183,miR-21-3p and miR-146bfor CHF complicated with pulmonary infection.RESULTS A total of 79strains of pathogenic bacteria were co-cultured and isolated from 46CHF patients complicated with pulmonary infection,which mainly included Klebsiella pneumonia(21.52%)and Pseudomonas aeruginosa(17.72%).The levels of peripheral blood miR-183,miR-21-3p and miR-146bin CHF and CHF complicated with pulmonary infection group were significantly higher than those in the control group(P<0.05),and the peripheral blood miR-183,miR-21-3p and miR-146bin CHF complicated with pulmonary infection group were significantly higher than those in CHF group(P<0.05).With the worsening of pulmonary infection,levels of peripheral blood miR-183,miR-21-3p and miR-146bof patients in CHF complicated with pulmonary infection group were significant
作者
王晓明
杨鹏伟
汪玲
谢力民
李楠
王记培
WANG Xiao-ming;YANG Peng-wei;WANG Ling;XIE Li-min;LI Nan;WANG Ji-pei(Henan Chest Hospital,Zhengzhou,Henan 450008,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第19期2993-2997,共5页
Chinese Journal of Nosocomiology
基金
河南省卫健委联合共建基金资助项目(LHGJ20190737)。
