摘要
目的探讨急性心肌梗死(AMI)合并肺部感染患者痰标本病原学特点及心肌酶谱与炎症因子水平变化。方法选取2021年1-3月武汉市东西湖区人民医院收治的130例AMI患者为病例组,其中合并肺部感染26例(感染组)和未合并感染104例(未感染组),另选取56名健康体检者为对照组。分析肺部感染痰标本分离病原菌分布特点,检测心肌酶谱[谷草转氨酶(AST)、乳酸脱氢酶(LDH)、高敏肌钙蛋白(hsTnl)、肌酸激酶同工酶(CK-MB)]及炎性因子[降钙素原(PCT)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)指标水平,采用受试者工作特征(ROC)曲线分析炎性因子水平诊断急性心肌梗死患者合并肺部感染的价值。结果26例AMI合并肺部感染患者痰培养分离出病原菌26株,其中革兰阳性菌及革兰阴性菌占比分别为42.31%、57.69%;病例组炎性因子及心肌酶谱水平均高于对照组(P<0.05),感染组炎性因子水平均高于未感染组(P<0.05)。ROC曲线分析结果显示,PCT、IL-6、TNF-α联合检测诊断急性心肌梗死合并肺部感染的曲线下面积为0.900。结论AMI合并肺部感染患者分离病原菌以革兰阴性菌为主,炎症因子及心肌酶谱指标均呈高表达,且PCT、IL-6、TNF-α联合检测对AMI合并肺部感染具有较高的诊断价值。
OBJECTIVE To explore the etiological characteristics of sputum specimens of the acute myocardial infarction(AMI)complicated with pulmonary infection and analyze the changes of myocardial zymogram and inflammatory factors.METHODS A total of 130 patients with AMI who were treated in the People′s Hospital of Wuhan Dongxihu District from Jan to Mar 2021 were assigned as the case group,26 of whom were complicated with infection and set as the infection group,and 104 were not complicated with infection and set as the no infection group.Totally 56 people who received physical examination were chosen as the control group.The distribution of pathogens isolated from sputum specimens of the patients with pulmonary infection was observed,the levels of myocardial zymogram[aspartate aminotransferase(AST),lactate dehydrogenase(LDH),high-sensitivity troponin(hsTnl),creatine kinase isoenzyme(CK-MB)]and inflammatory factors[procalcitonin(PCT),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]were detected,and the values of inflammatory factors in diagnosis of pulmonary infection in the AMI patients were analyzed by using receiver operating characteristic(ROC)curves.RESULTS Totally 26 strains of pathogens were isolated from the sputum specimens of the 26 AMI patients complicated with pulmonary infection,42.31%of which were gram-positive bacteria,and 57.69%were gram-negative bacteria.The levels of inflammatory factors and myocardial zymogram of the case group were higher than those of the control group(P<0.05);the levels of inflammatory factors of the infection group were higher than those of the no infection group(P<0.05).ROC curve analysis showed that the area under curve of the joint detection of PCT,IL-6 and TNF-αwas 0.900 in diagnosis of pulmonary infection in the patients with AMI.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the AMI patients complicated with pulmonary infection.The patients show high expressions of inflammatory factors and myocardial zymogram indexes.The joint d
作者
刘立新
童绥菊
袁海涛
万敏
付薇
LIU Li-xin;TONG Sui-ju;YUAN Hai-tao;WAN Min;FU Wei(People's Hospital of Wuhan Dongihu District,Wuhan,Hubei 430000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第10期1482-1485,共4页
Chinese Journal of Nosocomiology
基金
湖北省卫生健康委员会科研项目(WJ2021F016)。
关键词
急性心肌梗死
肺部感染
心肌酶谱
炎性因子
诊断价值
Acute myocardial infarction
Pulmonary infection
Myocardial zymogram
Inflammatory factor
Diagnostic value
