unASSIGNED:探讨慢性心力衰竭住院患者肺部感染的致病特征以及可溶性髓系细胞表达触发受体-1(sTREM-1)的诊断价值。可溶性CD163(sCD163)和可溶性肿瘤坏死因子样弱诱导因子(sTWEAK)。
UNASSIGNED:2017年12月至2019年12月河北省保定华英中医院心内科收治的慢性心力衰竭住院的肺部感染患者共72例,中国,被选为感染组,选择72例因慢性心力衰竭住院的无肺部感染患者作为非感染组,选取同期在医院进行体检的健康体检者50例作为对照组。对感染组病原菌分布特征进行统计学分析。比较3组不同感染程度和不同心功能分级患者血清中sTREM-1、SCD163和STweak水平。采用受试者工作特征曲线(ROC)评价3项指标对住院患者不良预后的预测价值。
UNASSIGNED:从2例慢性心力衰竭肺部感染住院患者中培养出76株病原体,其中革兰阴性菌43株(56.58%),革兰阳性菌29株(38.15%),4株(5.26%)为真菌。对照组的sTREM-1和sCD163水平,非感染组及感染组均逐渐增高(p<0.05),而感染组和非感染组sTWEAK无差异(p>0.05)。在感染组中,sTREM-1和sCD163的表达水平随着感染的严重程度而增加,差异有统计学意义(p<0.05),而sTWEAK在不同感染严重程度间的表达水平差异无统计学意义(p>0.05)。感染组患者心功能分级越高,sTREM-1和sCD163的水平越高,而sTWEAK的水平越低,具有统计学意义(p<0.05)。ROC分析结果显示,CHF合并肺部感染患者预后不良的血清sTREM-1、sCD163和sTWEAK水平曲线下面积分别为0.864、0.870和0.822,和95%CI值分别为0.787-0.941,0.795-0.945和0.733-0.910,所有p<0.001。
UNASSIGNED:慢性心力衰竭住院患者的肺部感染主要由革兰阴性菌引起。检测sTREM-1、sCD163和sTWEAK水平对判断病情和预后有一定的价值,值得临床推广。
UNASSIGNED: To investigate the pathogenic characteristics of pulmonary infection in hospitalized patients with chronic heart failure as well as the diagnostic value of soluble myeloid cell expression triggering receptor-1 (sTREM-1), soluble CD163 (sCD163) and soluble tumor necrosis factor-like weak inducing factor (
sTWEAK).
UNASSIGNED: A total of 72 patients with pulmonary infection who were hospitalized with chronic heart failure from December 2017 to December 2019 in the Department of Cardiology of Hebei Baoding Huaying Hospital of Traditional Chinese Medicine, China, were selected as the infection group, seventy-two patients without pulmonary infection who were hospitalized with chronic heart failure were selected as the non-infection group, and 50 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group. The distribution characteristics of pathogens in the infection group were statistically analyzed. The levels of sTREM-1, S CD163 and
STweak in serum of patients with different infection severity and different cardiac function grades were compared among the three groups. Receiver operating characteristic curve (ROC) was utilized to evaluate the predictive value of the three indicators for the adverse prognosis of patients in hospital.
UNASSIGNED: A total of 76 strains of pathogens were cultured from two hospitalized patients with pulmonary infection of chronic heart failure, among which 43 strains (56.58%) were gram-negative bacteria, 29 strains (38.15%) were gram-positive bacteria, and four strains (5.26%) were fungi. The levels of sTREM-1 and sCD163 in the control group, non-infection group and infection group were gradually increased (p<0.05), while there was no difference in sTWEAK between the infection group and the non-infection group (p>0.05). In the infection group, the expression levels of sTREM-1 and sCD163 increased with the severity of infection, with statistically significant differences (p<0.05), while there was no statistically significant difference in the expression level of
sTWEAK among different infection severity (p>0.05). The higher the cardiac function grade of patients in the infection group, the higher the levels of sTREM-1 and sCD163, and the lower the level of sTWEAK, with a statistical significance (p<0.05). ROC analysis results showed that the serum sTREM-1, sCD163, and
sTWEAK levels for the poor prognosis of patients with CHF combined with lung infection had areas under the curve of 0.864, 0.870, and 0.822, respectively, and the 95% CI values were 0.787-0.941, 0.795-0.945 and 0.733-0.910, respectively, all p<0.001.
UNASSIGNED: Pulmonary infection in hospitalized patients with chronic heart failure is mainly caused by gram-negative bacteria. Detection of sTREM-1, sCD163, and
sTWEAK levels is of certain value in judging the condition and prognosis, which is worthy of clinical promotion.