摘要
目的探讨卒中相关性肺炎(SAP)患者血清中白细胞介素-38(IL-38)的表达水平及其临床意义。方法选择2020年6月-2021年12月期间于徐州医科大学附属医院神经内科住院的72例SAP患者为研究组,选择85例同期确诊为急性缺血性卒中(AIS)患者为对照组。比较两组患者基本临床资料以及血清IL-38的表达水平。采用单因素和多因素logistic回归分析筛选SAP的危险因素,基于受试者工作特征(ROC)曲线评估IL-38在SAP中的预测价值。结果与对照组比较,研究组中吞咽困难占比(7.06%vs.25.00%)(χ^(2)=6.089,P=0.014)和NIHSS评分[(9.13±4.54)分vs.(15.58±5.15)分](t=-5.728,P<0.001)均更高,且血清中IL-38[(170.78±50.20)ng/L vs.(96.33±34.92)ng/L](t=-7.126,P<0.001)水平较低,差异均有统计学意义。Logistic回归分析显示,IL-38和NIHSS评分为SAP发生的危险因素(P<0.05)。ROC曲线结果显示,IL-38为155.15 pg/mL时,预测诊断SAP的曲线下面积(AUC)为0.902,灵敏度为68.5%,特异度为96.2%。结论IL-38在SAP患者血清中低表达,可作为SAP发生的新型早期预警生物标志物。
Objective For the sake of exploring interleukin-38(IL-38)expression levels in the serum of patients with strokeassociated pneumonia(SAP),we tried to search for the clinical significance of diagnosis and therapy value of different IL-38expression levels in SAP patients.Methods From June 2020 to December 2021,72 patients diagnosed with acute ischemic stroke complicated by pulmonary infection in hospitalization in the Affiliated Hospital of Xuzhou Medical University were noted as the observation groups,and 85 patients who suffered from an acute ischemic stroke but were not with pulmonary infection in hospitalization were noted as the control group in the same period.The basic clinical data and IL-38 expression level in serum between the two groups were compared;risk factors for SAP were screened based on binary logistic regression analysis,and the predicted value of IL-38 in SAP was evaluated based on the receiver operating characteristic(ROC)curve.Results The percentage of dysphagia(7.06%vs.25.00%)(χ^(2)=6.089,P=0.014)and NIHSS score[(9.13±4.54)vs.(15.58±5.15)](t=-5.728,P<0.001)were significantly higher in the study group than those in the control group,and IL-38[(170.78±50.20)ng/L vs.(96.33±34.92)ng/L](t=-7.126,P<0.001)was lower,the difference was statistically significant.The logistic regression analysis showed that the IL-38 and the NIHSS score were the risk factors for SAP occurrence(P<0.05).The ROC curve showed that when the serum IL-38 was 150.65 pg/mL,the area under the curve predicting the diagnosis of SAP was 0.902,the sensitivity was 68.5%,and the specificity was 96.2%.Conclusion The expression of IL-38 was decreased in patients with SAP;IL-38 expression abnormalities could provide a theoretical basis for the diagnosis and treatment of SAP and might be used as a novel biological marker for predicting concurrent pulmonary infection in the early stage of acute ischemic stroke.
作者
王莹莹
张周傲
徐铭铭
闫利莎
黄小雨
张勇
WANG Ying-ying;ZHANG Zhou-ao;XU Ming-ming;YAN Li-sha;HUANG Xiao-yu;ZHANG Yong(Department of Neurology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)
出处
《热带医学杂志》
CAS
2023年第1期46-49,共4页
Journal of Tropical Medicine
基金
江苏省研究生科研与实践创新计划项目(SJCX22_1270)
作者简介
王莹莹(1995-),女,在读硕士研究生,医师,研究方向为脑血管疾病、神经免疫疾病;通信作者:张勇,E-mail:zy2003njmu@163.com
