切换至 "中华医学电子期刊资源库"

中华肺部疾病杂志(电子版) ›› 2021, Vol. 14 ›› Issue (02) : 201 -204. doi: 10.3877/cma.j.issn.1674-6902.2021.02.014

临床研究

血清hs-CRP、NGAL检测对脑卒中患者肺部感染预后临床意义
彭海莹1, 解翠环1   
  1. 1. 250031 济南,山东省立第三医院
  • 收稿日期:2020-08-15 出版日期:2021-04-25

Clinical significance of serum hs­CRP and NGAL in the prognosis of pulmonary infection in stroke patients

Haiying Peng1, Cuihuan Xie1   

  • Received:2020-08-15 Published:2021-04-25
引用本文:

彭海莹, 解翠环. 血清hs-CRP、NGAL检测对脑卒中患者肺部感染预后临床意义[J]. 中华肺部疾病杂志(电子版), 2021, 14(02): 201-204.

Haiying Peng, Cuihuan Xie. Clinical significance of serum hs­CRP and NGAL in the prognosis of pulmonary infection in stroke patients[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(02): 201-204.

目的

探讨血清超敏C反应蛋白(hs-CRP)、中性粒细胞明胶酶相关脂质蛋白(NGAL)联合检测对脑卒中后肺部感染预后临床分析。

方法

选取2018年10月至2020年9月我院收治的91例脑卒中并发肺部感染患者为对象。随访3个月,统计预后不良发生情况,分为预后不良组28例和预后良好组63例;对比患者的临床资料;Logistic多因素回归分析影响脑卒中患者肺部感染预后。分析联合检测血清hs-CRP、NGAL对脑卒中患者肺部感染预后不良的预测。

结果

脑卒中患者肺部感染预后不良发生率为30.76%(28/91)。预后不良组脑卒中重度/重度占比、病原菌多重耐药占比、空腹血糖、住院时间、收缩压、舒张压、WBC、NIHSS评分、血清hs-CRP及NGAL水平均显著高于预后良好组(P<0.05)。Logistic回归分析,多因素分析结果显示,白细胞计数(WBC)、血清hs-CRP及NGAL均为脑卒中患者肺部感染预后不良发生的影响因素(OR=2.765、3.499、3.766、4.289,P<0.05)。ROC分析显示,血清hs-CRP、NGAL预测脑卒中患者肺部感染预后不良的最佳截断点分别为20.02 mg/L、37.08 ng/ml,两者联合的特异度为95.12%,高于血清hs-CRP、NGAL单独进行评估的特异度(76.83%、68.29%),且血清hs-CRP、NGAL两者联合预测脑卒中患者肺部感染预后不良的曲线下面积(AUC)为0.841,显著高于血清hs-CRP、NGAL单独预测的AUC(0.662、0.729)。

结论

联合检测血清hs-CRP、NGAL对脑卒中患者肺部感染预后不良的预测有临床意义。

表1 两组临床资料对比(±s)
表2 影响脑卒中患者肺部感染预后Logistic回归分析
1
黄其密,惠俊兰,刘唯佳,等. 老年脑卒中患者上消化道出血与肺部感染的临床分析[J]. 中华肺部疾病杂志(电子版), 2016, 9(3): 324-326.
2
Wen SW, Shim R, Ho L, et al. Advanced age promotes colonic dysfunction and gut-derived lung infection after stroke[J]. Aging Cell, 2019, 18(5): 129-135.
3
Shim R, Wen SW, Wanrooy BJ, et al. Stroke severity, and not cerebral infarct location, increases the risk of infection[J]. Transl Stroke Res, 2020, 11(3): 387-401.
4
Zhang SR, Nold MF, Tang SC, et al. IL-37 increases in patients after ischemic stroke and protects from inflammatory brain injury, motor impairment and lung infection in mice[J]. Sci Rep, 2019, 9(1): 6922.
5
Wan G, Wang L, Zhang G, et al. Effects of probiotics combined with early enteral nutrition on endothelin-1 and C-reactive protein levels and prognosis in patients with severe traumatic brain injury[J]. J Int Med Res, 2020, 48(3): 305-312.
6
Cai Z, He W, Zhuang FJ, et al. The role of high high-sensitivity C-reactive protein levels at admission on poor prognosis after acute ischemic stroke[J]. Int J Neurosci, 2019, 129(5): 423-429.
7
邱承高. 血清NGAL、Fetuin A、白细胞介素-6与腹膜透析相关感染程度相关性及对预后的影响[J]. 安徽医药,2020, 13(8): 25-31.
8
崔丽英. 脑卒中防治[M]. 北京:科学出版社,2011: 215-227.
9
吴小军,聂汉祥. 呼吸系统疾病并发症鉴别预测与治疗[M]. 上海:科学技术文献出版社,2011: 158-165.
10
Austin V, Ku JM, Miller AA, et al. Ischaemic stroke in mice induces lung inflammation but not acute lung injury[J]. Sci Rep, 2019, 9(1): 3622.
11
De Marchis GM, Katan M, Weck A, et al. Copeptin and risk stratification in patients with ischemic stroke and transient ischemic attack: the CoRisk study[J]. Int J Stroke, 2013, 8(3): 214-218.
12
Jin R, Liu S, Wang M, et al. Inhibition of CD147 attenuates stroke-associated pneumonia through modulating lung immune response in mice[J]. Front Neurol, 2019, 10(6): 853.
13
de Jonge JC, Takx RAP, Kauw F, et al. Signs of pulmonary infection on admission chest computed tomography are associated with pneumonia or death in patients with acute stroke[J]. Stroke, 2020, 51(6): 1690-1695.
14
Dames C, Winek K, Beckers Y, et al. Immunomodulatory treatment with systemic GM-CSF augments pulmonary immune responses and improves neurological outcome after experimental stroke[J]. J Neuroimmunol, 2018, 321(13): 144-149.
15
Shah P, Birk SE, Cooper LB, et al. Stroke and death risk in ventricular assist device patients varies by ISHLT infection category: An INTERMACS analysis[J]. J Heart Lung Transplant, 2019, 38(7): 721-730.
16
邓霁红,颜 可,蒋汉刚. 血小板计数,降钙素原联合简化临床肺部感染评分预测卒中后肺部感染患者预后的价值[J]. 实用医院临床杂志,2020, 17(2): 147-150.
17
Shen Y, Chen Y, Huang Z, et al. Associations between untraditional risk factors, pneumonia/lung cancer, and hospital fatality among hypertensive men in Guangzhou downtown[J]. Sci Rep, 2020, 10(1): 1425.
18
李玉莲,史天奇,王喜亚,等. 急性脑卒中患者肺部感染预后的影响因素分析[J]. 中华医院感染学杂志,2016, 26(14): 3213-3215.
19
Warnecke G, Van Raemdonck D, Smith MA, et al. Normothermic ex-vivo preservation with the portable organ care system lung device for bilateral lung transplantation (inspire): a randomised, open-label, non-inferiority, phase 3 study[J]. Lancet Respir Med, 2018, 6(5): 357-367.
20
Karasahin O, Tasar PT, Timur O, et al. The value of C-reactive protein in infection diagnosis and prognosis in elderly patients[J]. Aging Clin Exp Res, 2018, 30(6): 555-562.
21
Wang L. C-reactive protein levels in the early stage of COVID-19[J]. Med Mal Infect, 2020, 50(4): 332-334.
22
Ciccacci F, Welu B, Ndoi H, et al. High-sensitivity C-reactive protein in HIV care: tuberculosis diagnosis and short-term mortality in a cohort of kenyan hiv patients in the dream programme[J]. Int J Infect Dis, 2021, 104(18): 329-334.
23
Gomes BC, Silva Júnior JM, Tuon FF. Evaluation of urinary NGAL as a diagnostic tool for acute kidney injury in critically ill patients with infection: an original study[J]. Can J Kidney Health Dis, 2020, 12(4): 53-60.
24
周 燕. 重症肺部感染患者机械通气前后hs-CRP,PCT的变化情况及其与患者预后的关系分析[J]. 标记免疫分析与临床,2018, 25(2): 215-219+223.
25
Castro AR, Silva SO, Soares SC. The use of high sensitivity c-reactive protein in cardiovascular disease detection[J]. J Pharm Pharm Sci, 2018, 21(1): 496-503.
26
Park HB, Gwark JY, Jung J, et al. Association between high-sensitivity c-reactive protein and idiopathic adhesive capsulitis[J]. J Bone Joint Surg Am, 2020, 102(9): 761-768.
27
Adibian M, Hodaei H, Nikpayam O, et al. The effects of curcumin supplementation on high-sensitivity C-reactive protein, serum adiponectin, and lipid profile in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled trial[J]. Phytother Res, 2019, 33(5): 1374-1383.
28
Colak S, Omma A, Sandikci SC, et al. Vaspin, neutrophil gelatinase-associated lipocalin and apolipoprotein levels in patients with psoriatic arthritis[J]. Bratisl Lek Listy, 2019, 120(1): 65-69.
29
Studená Š,Doleželová E, Cermanová J, et al. Evaluation of neutrophil gelatinase-associated lipocalin as a predictor of glomerular filtration rate and amikacin clearance during early rat endotoxemia: comparison with traditional endogenous and exogenous biomarkers[J]. Eur J Drug Metab Pharmacokinet, 2020, 45(1): 71-80.
30
王丽丽,王莉华,高永宁,等. 尿毒症维持性血液透析合并肺部感染患者血清NGAL和MMP-9的表达水平[J].中华医院感染学杂志,2020, 30(12): 1835-1839.
[1] 农云洁, 黄小桂, 黄裕兰, 农恒荣. 超声在多重肺部感染诊断中的临床应用价值[J]. 中华医学超声杂志(电子版), 2024, 21(09): 872-876.
[2] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[3] 张志兆, 王睿, 郜苹苹, 王成方, 王成, 齐晓伟. DNMT3B与乳腺癌预后的关系及其生物学机制[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 624-629.
[4] 屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[5] 顾雯, 凌守鑫, 唐海利, 甘雪梅. 两种不同手术入路在甲状腺乳头状癌患者开放性根治性术中的应用比较[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 687-690.
[6] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[7] 孙建娜, 孔令军, 任崇禧, 穆坤, 王晓蕊. 266例首诊Ⅳ期乳腺癌手术患者预后分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 502-505.
[8] 袁庆港, 刘理想, 张亮, 周世振, 高波, 丁超, 管文贤. 尿素-肌酐比值(UCR)可预测结直肠癌患者术后的长期预后[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 506-509.
[9] 黄福, 王黔, 金相任, 唐云川. VEGFR2、miR-27a-5p在胃癌组织中的表达与临床病理参数及预后的关系研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(05): 558-561.
[10] 张瑜, 姜梦妮. 基于DWI信号值构建局部进展期胰腺癌放化疗生存获益预测模型[J]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 657-664.
[11] 肖丹, 陈辰, 查晔军, 公茂琪, 花克涵, 孙伟桐, 蒋协远. 改良松解术治疗创伤后肘关节僵硬的疗效及危险因素分析[J]. 中华老年骨科与康复电子杂志, 2024, 10(05): 257-263.
[12] 李素娟, 王文玲, 董洪敏, 李小凯, 黄思成, 王刚. 多原发与单原发大肠腺癌的预后分析[J]. 中华消化病与影像杂志(电子版), 2024, 14(05): 407-412.
[13] 孙文恺, 沈青, 杭丽, 张迎春. 纤维蛋白原与清蛋白比值、中性粒细胞与白蛋白比值、C反应蛋白与溃疡性结肠炎病情评估和预后的关系[J]. 中华消化病与影像杂志(电子版), 2024, 14(05): 426-431.
[14] 郭曌蓉, 王歆光, 刘毅强, 何英剑, 王立泽, 杨飏, 汪星, 曹威, 谷重山, 范铁, 李金锋, 范照青. 不同亚型乳腺叶状肿瘤的临床病理特征及预后危险因素分析[J]. 中华临床医师杂志(电子版), 2024, 18(06): 524-532.
[15] 闫战涛, 王辉, 周梓迪, 史勇强, 陈铜兵. 胃淋巴上皮瘤样癌三级淋巴结构特征及其与预后的相关性[J]. 中华临床医师杂志(电子版), 2024, 18(05): 455-461.
阅读次数
全文


摘要