摘要
目的:探讨老年特发性肺间质纤维化(IPF)合并感染对血清白细胞介素(IL)-4、触珠蛋白(HP)、淀粉样蚕白A(SAA)表达的影响,并分析患者病原菌特征。方法:选取我院老年IPF合并感染患者86例为观察组,另选取同期未合并感染老年IPF患者86例为对照组。分析观察组病原菌特征,比较两组基线资料、肺部感染评分(CPIS)、血清IL-4、SAA、HP表达。采用Pearson相关性分析IL-4、SAA、HP与CPIS评分的相关性。Logistic多因素回归分析IPF合并感染的影响因素。受试者工作曲线(ROC)检测IL-4、SAA、HP对老年IPF合并感染的预测价值及与与病原菌类型的关系。结果:86例老年IPF合并感染患者痰培养标本共培养出病原菌97株,其中革兰氏阴性菌61株,革兰氏阳性菌20株,真菌16株;观察组血清IL-4、SAA、HP表达高于对照组(PV0.05);血清IL-4、SAA、HP与老年IPF合并感染患碧CPIS评分均呈正相关,性(P<0.05);将年龄、糖尿病等因素控制后,血清IL-4、SAA、HP表达均与老牟IPF合并感染发生有关(PC0.05);血清IL-4、SAA、HP联合预测老年IPF合并感染的曲线下面积(AUC)最大,为0.895;血清IL-4、SAA、HP表达各组间比较,老年IPF合并革兰氏阴性菌感染〉革兰氏阳性菌〉真菌(P<0.05)。结论:革兰氏阴性菌是引起老年IPF合并感染的主要病原菌,联合检测血清IL-4、SAA、HP表达,可为临床预测感染、区分病原菌类型、开展合理有效抗生素治疗提供新思路。
Objective:To investigate the efiect of senile idiopathic pulmonary fibrosis(IPF) co-infection on the expression of serum interleukin(IL)-4,haptoglobin(HP)and amyloid A(SAA),and to analyze the characteristics of pathogenic bacteria in patients.Methods:A total of 86 elderly patients with IPF infection in our hospital were selected as the observation group,and 86 elderly patients without IPF infection during the same period were selected as the control group.The characteristics of pathogenic bacteria in the observation group were analyzed,and the baseline data,pulmonary infection score(CPIS),and serum IL-4,SAA,and HP expressions were compared between the two groups.Pearson correlation,was used to analyze the correlation between IL-4,SAA,HP and CPIS scoreXogistic multivariate regression analysis of the influencing factors ofIPF co-infection.Receiver operating curve(ROQ) detection ofIL-4,SAA,HP in the predictive value of senile IPF co-infection and its relationship with the type of pathogenic bacteria.Results:A total of 97 strains of pathogenic bacteria were cultured in sputum specimens from 86 elderly patients with IPF co-infection,including 61 strains of Gram-negative bacteria,20 strains of Gram-positive bacteria,and 16 strains of fungi The expressions of serum IL-4,SAA and HP in the observation group were higher than those in the control group(P<0.05);Serum IL-4,SAA,HP were positively correlated with the CPIS score of elderly patients with IPF infection(P<0.05).After controlling for age,diabetes and other factors,the expressions of serum IL-4,SAA and HP were all related to the occurrence ofIPF infection in the elderly(P<0.05);The area under the curve(AUC)of serum IL-4,SAA and HP combined to predict senile IPF comorbid infection was the largest,which was 0.895;The comparison of serum IL-4,SAA and HP expression among each group showed that elderly IPF compEcated with gram-negative bacteria infection>gram-positive bacteria>fungi(P<0.05).Con elusion:Gram-negative bacteria are the main pathogenic bacteria that cause senile IPF co-infection.Combined detection of serum IL-4,SAA and HP expression can provide new ideas for clinical prediction of infection,difierentiation of pathogenic bacteria types,and reasonable and efiective antibiotic treatment.
作者
王倩
徐国超
WANG Qian;XU Guochao(Department of Laboratory Medicine,Xinxiang Second People's Hospital,Henan Xinxiang 453000)
出处
《医学检验与临床》
2022年第10期21-26,共6页
Medical Laboratory Science and Clinics
