摘要
目的探究微小核糖核酸(miR)-5787、miR-146a及miR-133在经皮冠状动脉介入治疗(PCI)术后肺部感染患者中表达水平及其与机体炎症、凝血纤溶因子水平的关系.方法将山东大学第四人民医院2021年7月—2023年7月收治的131例冠心病PCI患者术后发生肺部感染和未发生肺部感染的患者分别纳入感染组(26例)和非感染组(105例);比较两组miR-5787、miR-146a、miR-133及机体炎症、凝血纤溶因子水平;采用Pearson分析miR-5787、miR-146a、miR-133与机体炎症、凝血纤溶因子的相关性;采用受试者工作特征曲线(ROC)分析miR-5787、miR-146a、miR-133对冠心病PCI患者术后肺部感染的诊断价值.结果感染组血清miR-5787、miR-146a、miR-133、E选择素、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、C-反应蛋白(CRP)及血浆纤维蛋白原(FIB)、D-二聚体(D-D)、组织纤溶酶原抑制物(PAI)、血管性血友病因子(vWF)水平高于非感染组(P<0.05),抗凝血酶-Ⅲ(AT-Ⅲ)水平低于非感染组(P<0.05);miR-5787、miR-146a、miR-133与E选择素、TNF-α、IL-6、CRP、FIB、D-D、PAI、vWF水平呈正相关(P<0.05),与AT-Ⅲ水平呈负相关(P<0.05);miR-5787、miR-146a、miR-133联合检测诊断冠心病PCI患者术后肺部感染曲线下面积(AUC)值高于各项单一检测(P<0.05),且联合检测敏感度为96.15%,特异度为80.00%.结论冠心病PCI术后肺部感染患者miR-5787、miR-146a、miR-133、机体炎症、凝血纤溶系统表达异常;miR-5787、miR-146a、miR-133与机体炎症、凝血纤溶因子有相关性,且三者联合检测可提高冠心病PCI患者术后肺部感染的诊断价值.
OBJECTIVE To investigate the expression levels of microRNA(miR)-5787,miR-146a and miR-133 in patients with pulmonary infection after percutaneous coronary intervention(PCI)and their relationship with the factors related to body inflammation,coagulation and fibrinolysis.METHODS A total of 131 patients with coro-nary heart disease undergoing PCI admitted to the Fourth People's Hospital of Jinan from Jul 2021 to Jul 2023 were divided into the infected group(26 cases)and non-infected group(105 cases).The levels of miR-5787,miR-146a,miR-133 and factors related to inflammatory,coagulation and fibrinolysis were compared between the two groups.Pearson analysis was used to analyze the correlation of miR-5787,miR-146a and miR-133 with factors in inflammation,coagulation and fibrinolysis.The receiver operating characteristic curve(ROC)was used to analyze the diagnostic value of miR-5787,miR-146a and miR-133 in pulmonary infection in patients with coronary heart disease after PCI.RESULTS The serum levels of miR-5787,miR-146a,miR-133,E-selectin,tumor necrosis fac-tor(TNF)-a,interleukin(IL)-6 and C-reactive protein(CRP),the levels of plasma fibrinogen(FIB),D-dimer(D-D),plasminogenemia activator inhibitor(PAI),von Willebrand factor(vWF),were higher than those in the non-infected group(P<0.05),and antithrombin-Ⅲ(AT-Ⅲ)were lower than those in the non-infected group(P<0.05).The miR-5787,miR-146a and miR-133 levels were positively correlated with E-selectin,TNF-α,IL-6,CRP,FIB,D-D,PAI and vWF levels(P<0.05),and negative correlation with the level of AT-Ⅲ(P<0.05).The area under the curve(AUC)value of combined detection of miR-5787,miR-146a and miR-133 in the diagnosis of pulmonary infection in patients with coronary heart disease after PCI was higher than that of single de-tection(P<0.05);and the sensitivity and specificity of combined detection was 96.15%and 80.00%,respectov-ely.CONCLUSION The expression of miR-5787,miR-146a,miR-133,body inflammation,and factors related to coagulation and fibrinolysis system were abnormal in patients with coronary heart disease and postoperative pul-monary infection after PCI.The miR-5787,miR-146a,and miR-133 were correlated with the levels of inflamma-tion,coagulation and fibrinolysis factors.The combined detection of the three indexes can improve the diagnostic value of pulmonary infection in patients with coronary heart disease after PCI.
作者
李晓荣
张小丽
王冰
张秀杰
LI Xiao-rong;ZHANG Xiao-li;WANG Bing;ZHANG Xiu-jie(Jinan Fourth People's Hospital,Jinan,Shandong 250031,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第15期2352-2356,共5页
Chinese Journal of Nosocomiology
基金
山东省体卫融合试点项目(2022-2-6)山东大学科技发展计划项目(2019-2-15)。
关键词
冠心病
经皮冠状动脉介入治疗
肺部感染
微小核糖核酸
炎症
凝血纤溶因子
相关性
受试者工作特征曲线
Coronary heart disease
Percutaneous coronary intervention
Pulmonary infection
Microrna
Inflam-mation
Coagulation and fibrinolytic factors
Correlation
Receiver operating characteristic curve
