摘要
目的分析耐碳青霉烯类肺炎克雷伯菌感染患者核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、C-反应蛋白/白蛋白(CRP/ALB)、白介素-6(IL-6)表达水平及其预后相关影响因素。方法2022年1月至2023年6月中江县人民医院、成都市第二人民医院、德阳市人民医院收治的294例耐碳青霉烯类肺炎克雷伯菌感染患者进行研究,根据预后情况分为预后不良组51例、预后良好组243例。通过单因素、多因素分析耐碳青霉烯类肺炎克雷伯菌感染患者预后的影响因素,比较不同预后患者NLRP3、CRP/ALB、IL-6表达水平,绘制受试者工作特征(ROC)曲线分析NLRP3、CRP/ALB、IL-6单独及联合检测对耐碳青霉烯类肺炎克雷伯菌感染患者预后的预测价值。结果预后不良组患者年龄、病情危重程度为重度、深静脉置管、糖尿病、多器官功能衰竭、使用血管活性药物、使用镇静药、使用强心类药物比例高于预后良好组(P<0.05)。多因素Logistic分析结果显示病情危重程度为重度、深静脉置管、多器官功能衰竭、使用血管活性药物为耐碳青霉烯类肺炎克雷伯菌感染患者预后不良的危险因素(P<0.05)。与预后良好组比较,预后不良组血清NLRP3、CRP/ALB、IL-6水平更高(P<0.05)。绘制ROC曲线分析NLRP3、CRP/ALB、IL-6指标联合检测对耐碳青霉烯类肺炎克雷伯菌感染预后不良的预测价值最高,曲线下面积(AUC)为0.910,敏感性86.27%,特异性为87.24%。结论耐碳青霉烯类肺炎克雷伯菌感染患者存在预后不良风险,危险因素较多,联合检测NLRP3、CRP/ALB、IL-6对其预测价值较高。
Objective To analyze the expression levels of nucleotide-binding oligomeric domainlike receptor protein 3(NLRP3),C-reactive protein/albumin(CRP/ALB)and interleukin-6(IL-6)in carbapenem-resistant Klebsiella pneumoniae infection and the factors related to prognosis.Methods A total of 294 patients with carbapenem-resistant Klebsiella pneumoniae infection were admitted to Zhongjiang County People's Hospital,Chengdu Second People's Hospital,and Deyang People's Hospital from January 2022 to June 2023.They were divided into two groups based on their prognosis:the poor prognosis group(51 patients)and the good prognosis group(243 patients).The prognostic factors in patients with carbapenem-resistant Klebsiella pneumoniae infection were analyzed using both univariate and multivariate methods.Additionally,the expression levels of NLRP3,CRP/ALB,and IL-6 were compared between patients with different prognoses.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of NLRP3,CRP/ALB and IL-6 individually and in combination for carbapenem-resistant Klebsiella pneumoniae infection.Results The proportion of patients in the poor prognosis group was higher than that in the good prognosis group in terms of age,severity,deep venous catheter use,diabetes,multiple organ failure,use of vasoactive drugs,sedative drugs and cardiac drugs(P<0.05).Multivariate logistic analysis showed that severe disease severity,deep venous catheterization,multiple organ failure and use of vasoactive drugs were risk factors for poor prognosis in carbapenem-resistant Klebsiella pneumoniae infection(P<0.05).Compared to the good prognosis group,the levels of serum NLRP3,CRP/ALB,and IL-6 in the poor prognosis group were higher(P<0.05).ROC curve analysis of NLRP3,CRP/ALB and IL-6 combined detection for carbapenem-resistant Klebsiella pneumoniae infection had the highest predictive value for poor prognosis,with an area under the curve(AUC)of 0.910,sensitivity of 86.27%and specificity of 87.24%.Conclusion Patients with carbapenem-r
作者
唐萍
史梦
陈宗耀
曾海玲
TANG Ping;SHI Meng;CHEN Zongyao;ZENG Hailing(Zhongjiang County People's Hospital,Deyang,Sichuan,China,618100;Chengdu Second People's Hospital,Chengdu,Sichuan,China,618100;Deyang People's Hospital,Deyang,Sichuan,China,618100)
出处
《分子诊断与治疗杂志》
2024年第10期2000-2004,共5页
Journal of Molecular Diagnostics and Therapy
基金
德阳市科技计划项目(19ZDYF0039)。
