摘要
目的 分析血清Wnt5a、可溶性白细胞介素-2受体(sIL-2R)水平对老年2型糖尿病(T2DM)合并肺部感染的诊断价值,及与肺部感染病情严重程度、预后的关系。方法 选取2021年1月—2022年12月河南科技大学第一附属医院收治的84例老年T2DM合并肺部感染患者作为观察组,选取同期住院的30例T2DM患者作为糖尿病组,选取同期该院体检的健康志愿者30例作为对照组。比较3组Wnt5a、sIL-2R水平,绘制受试者工作特征(ROC)曲线评估Wnt5a、sIL-2R水平对老年T2DM合并肺部感染的诊断价值,采用Pearson法分析观察组Wnt5a、sIL-2R水平与实验室指标的相关性;将观察组根据肺部感染严重程度分为轻度、中度、重度3个亚组,比较3个亚组Wnt5a、sIL-2R水平;根据观察组预后情况分为康复组及死亡组,比较2个亚组Wnt5a、sIL-2R水平。结果 观察组及糖尿病组Wnt5a、sIL-2R、FPG较对照组升高(P <0.05),FEV1较对照组降低(P <0.05),观察组sIL-2R较糖尿病组升高(P <0.05),FEV1较糖尿病组降低(P <0.05)。84例患者共检出病原菌98株,其中革兰阳性菌最多(50.00%),革兰阴性菌其次(47.96%),真菌最少(2.04%)。联合检测的曲线下面积(AUC)、敏感性最高,分别为0.935(95%CI:0.873,0.973)、85.71%(95%CI:0.760,0.921),sIL-2R的特异性最高,为93.33%(95%CI:0.765,0.988)。Pearson相关性分析显示,Wnt5a、sIL-2R水平与FEV1水平呈负相关(r=-0.228和-0.227,均P <0.05)。Wnt5a、sIL-2R水平与FPG水平呈正相关(r=0.450和0.647,均P <0.05)。重度组Wnt5a、sIL-2R水平较轻度组高(P <0.05),中度组sIL-2R水平较轻度组高(P <0.05),重度组sIL-2R水平较中度组高(P <0.05)。死亡组Wnt5a、sIL-2R水平高于康复组(P <0.05)。结论 老年T2DM合并肺部感染患者血清Wnt5a、sIL-2R水平升高,其与患者肺功能、血糖水平有相关性,能够辅助临床判断T2DM患者是否具有肺部感染以及感染严重程度、预后情况。
Objective To analyze the diagnostic value of serum levels of Wnt5a and soluble interleukin-2 receptor(sIL-2R)for elderly patients with type 2 diabetes mellitus(T2DM)complicated by pulmonary infection and their relationship with severity and prognosis of pulmonary infection.Methods The 84 elderly patients with T2DM and pulmonary infection who were treated in our hospital between January 2021 and December 2022 were selected as the observation group,30 patients with T2DM who were hospitalized during the same period were selected as the diabetes mellitus group,and 30 healthy volunteers who came to the hospital for health checkup during the same period were selected as the control group.The levels of Wnt5a and sIL-2R were compared among the three groups,and receiver operating characteristic(ROC)curve was drawn to assess the diagnostic value of levels of Wnt5a and sIL-2R for elderly patients with T2DM and pulmonary infection.Pearson correlation analysis was performed to determine the correlations of the levels of Wnt5a and sIL-2R with other laboratory indicators of patients within the observation group.The patients in the observation group were further divided into mild,moderate and severe subgroups according to the severity of pulmonary infection,and the levels of Wnt5a and sIL-2R were compared among the three subgroups.According to the prognosis,the patients in the observation group were divided into the rehabilitation subgroup and the death subgroup,and the levels of Wnt5a and SIL-2R were also compared between the two subgroups.Results The levels of Wnt5a,sIL-2R,and FPG were higher(P<0.05),and FEV1 was lower in the observation group and the diabetes mellitus group compared with the control group(P<0.05).The level of sIL-2R was higher(P<0.05),and FEV1 was lower in the observation group than in the diabetes mellitus group(P<0.05).A total of 98 strains of pathogens were detected in 84 patients,among which Gram-positive bacteria were the most prevalent(50.00%),followed by Gram-negative bacteria(47.96%)and fungi(2.04%).T
作者
宋白利
曹书义
彭慧芳
付留俊
常毅娜
Song Bai-li;Cao Shu-yi;Peng Hui-fang;Fu Liu-jun;Chang Yi-na(Department of Endocrinology,College of Clinical Medicine of Henan University of Science and Technology(The First Affiliated Hospital of Henan University of Science and Technology),Luoyang,Henan 471003,China)
出处
《中国现代医学杂志》
CAS
2024年第10期7-13,共7页
China Journal of Modern Medicine
基金
河南省医学科技攻关计划项目(No:222102310008)。
