摘要
目的 探究血清Foxo1与Th9细胞对慢性难治性荨麻疹合并感染患者的评估价值及相关性。方法 选取2022年2月-2024年12月在本院接诊的120例慢性难治性荨麻疹患者作为研究对象,根据其是否发生感染分为感染组(n=30)和未感染组(n=60)。ELISA试剂盒检测血清Foxo1水平,流式细胞术检测Th9细胞比例。对比感染组和未感染组血清Foxo1与Th9细胞水平;ROC分析血清Foxo1与Th9细胞对慢性难治性荨麻疹合并感染患者的诊断价值;Logistic回归分析慢性难治性荨麻疹合并感染发生的影响因素;对比不同感染程度患者血清Foxo1与Th9细胞水平的差异。结果 30例感染患者分离出46株病原菌,以革兰阴性菌为主(28株,占60.87%),包括肺炎克雷伯菌(12株)、铜绿假单胞菌(8株)等;革兰阳性菌14株(占30.43%),以金黄色葡萄球菌(8株)居多;真菌4株(占8.70%)。肺炎克雷伯菌对头孢哌酮、头孢呋辛耐药率较高,铜绿假单胞菌对美洛西林敏感,鲍曼不动杆菌对β-内酰胺类抗生素耐药性强,金黄色葡萄球菌对青霉素类、头孢唑啉耐药,但对万古霉素、利奈唑胺敏感。感染组血清Foxo1和Th9细胞比例水平均显著高于未感染组(均P<0.05);Foxo1与Th9单独和联合检测诊断慢性难治性荨麻疹合并感染患者的AUC分别为0.825、0.838和0.926,联合检测诊断价值显著高于单独检测(均P<0.05);Logistic回归模型分析结果显示Foxo1与Th9均是慢性难治性荨麻疹合并感染发生的危险因素(P<0.05);重度感染患者血清Foxo1与Th9细胞比例水平明显高于轻度组和中度组,中度组血清Foxo1与Th9细胞比例水平明显高于轻度组(均P<0.05);Spearman相关性结果显示血清Foxo1与Th9细胞与感染程度均存在显著正相关(r=0.771、0.826,均P<0.05)。结论 血清Foxo1与Th9细胞对慢性难治性荨麻疹合并感染患者具有重要评估价值,二者在感染患者中水平更高且均为感染发生的危险因素,与感染程度正相关。而病原菌以革兰阴性菌为主,部分菌株耐药性较强,需结合药敏精准治疗。
Objective To explore the evaluation value and correlation of serum Foxo1 and Th9 cells in patients with chronic refractory urticaria complicated with infection.MethodsA total of 120 patients with chronic refractory urticaria who were admitted to our hospital from February 2022 to December 2024 were selected as the research subjects and were divided into the infection group(n=30)and the non-infection group(n=60)according to whether they had infection or not.The serum Foxo1 level was detected by ELISA kit,and the proportion of Th9 cells was detected by flow cytometry.The levels of serum Foxol and Th9 cells in the infected group and the uninfected group were compared.The diagnostic value of serum Foxol and Th9 cells for patients with chronic refractory urticaria complicated with infection was analyzed by ROC.The influencing factors of chronic refractory urticaria complicated with infection were analyzed by Logistic regression.The differences in serum Foxol and Th9 cell levels among patients with different degrees of infection were comparedR.Iesults A total of 46 pathogenic bacteria were isolated from 30 infected patients,mainly Gram-negative bacteria(28 strains,accounting for 60.87%),including Klebsiella pneumoniae(12 strains),Pseudomonas aeruginosa(8 strains),etc.There were 14 strains of Gram-positive bacteria(accounting for 30.43%),with Staphylococcus aureus(8 strains)being the majority.Four strains of fungi(accounting for 8.7o%).K.pneumoniae has a relatively high resistance rate to cefoperazone and cefuroxime.P.aeruginosa is sensitive to meloxicillin.Acinetobacter baumannii has strong resistance toβ-lactam antibiotics.S.aureus is resistant to penicillins and cefazolin,but sensitive to vancomycin and linezolid.The proportion levels of serum Foxol and Th9 cells in the infection group were significantly higher than those in the non-infection group(all P<0.05).The AUCs of Foxol and Th9 alone and in combination for diagnosing patients with chronic refractory urticaria complicated with infection were 0.825,0.838 and 0.926,respectively.The diagnostic value of the combined detection was significantly higher than that of the single detection(all P<0.05).The analysis results of the Logistic regression model showed that both Foxol and Th9 were risk factors for the occurrence of chronic refractory urticaria complicated with infection(P<0.05);The ratio level of serum Foxol to Th9 cells in patients with severe infection was significantly higher than that in the mild group and the moderate group,and the ratio level of serum Foxol to Th9 cells in the moderate group was significantly higher than that in the mild group(all P<0.05).The Spearman correlation results showed that both serum Foxol and Th9 cells were significantly positively correlated with the degree of infection(r=0.771,0.826;both P<0.05).Conclusion Serum Foxol and Th9 cells have significant evaluation value for patients with chronic refractory urticaria complicated with infection.Their levels are higher in infected patients and both are risk factors for infection,positively correlated with the degree of infection.The pathogenic bacteria are mainly Gram-negative bacteria,and some strains have strong drug resistance,which requires precise treatment in combination with drug sensitivity.
作者
张佳
张明海
陶飞雪
袁琳
姚珍芳
ZHANG Jia;ZHANG Minghai;TAO Feixue;YUAN Lin;YAO Zhenfang(Joint Ward of Rheumatology and Immunology Department,Dermatology and Venereology Department,the Fourth Affiliated Hospital of Anhui Medical University,Chaohu,Anhui 238000,China;Department of Dermatology and Venereology,the Fourth Affiliated Hospital of Anhui Medical University;Department of Nursing,the Fourth AffiliatedHospital ofAnhuiMedicalUniversity)
出处
《中国病原生物学杂志》
北大核心
2025年第10期1297-1301,共5页
Journal of Pathogen Biology
作者简介
通信作者:张明海,E-mail:10910326881qq.com;张佳(1988-),女,安徽巢湖人,本科,主管护师,主要从事风湿免疫科、皮肤性病科联合病区工作。E-mail:zj_chaohu@163.com。
