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探讨卒中相关肺炎相关生物标志物的水平及临床意义

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目的:本研究基于确认的卒中相关肺炎(Stroke-associated pneumonia,SAP)生物标志物的化学性质和物质结构对制备的纳米材料传感器进行修饰,从而实现对SAP生物标志物的检测,并评估其鉴别诊断SAP与非SAP的效果.方法:使用光化学法建立缺血性SAP模型大鼠,采用胶原酶注入法建立出血性SAP模型,然后将大鼠放入固定盒中,用酒精擦拭大鼠尾部,按压住尾静脉1/3处,注射器进针后回抽有血后注入脂多糖(Lipopolysaccharide,LPS)溶液(LPS溶于生理盐水,给药剂量10mg/kg),从而建立内毒素性急性肺损伤大鼠模型;采集血液样本,并将其置于不含抗凝剂的试管内;室温下自然凝集2~4h(防暴晒),血液凝固后自然析出的即血清;然后基于上转换纳米材料对确定的生物标志物进行荧光检测;采用受试者工作特征曲线(Receiver Operating Characteristic Curve,ROC曲线)评估其鉴别诊断SAP与非SAP的效果.结果:SAP与非SAP大鼠的降钙素原(Procalcitonin,PCT)及尿酸(Uric acid,UA)水平没有统计学差异,而SAP组的C-反应蛋白(C-reactive protein,CRP)水平明显高于非SAP组大鼠,差异具有统计学差异(P<0.05);采用ROC曲线,评估主要生物标志物水平鉴别SAP与非SAP大鼠的价值,结果显示CRP水平对鉴别SAP与非SAP大鼠具有较高的临床价值(P<0.05).结论:SAP与非SAP大鼠间CRP比较具有明显差异,而PCT、尿酸比较无明显差异,CRP可作为鉴别SAP与非SAP大鼠的可靠性指标.
To Investigate the Level and Clinical Significance of Biomarkers Associated with Stroke-Related Pneumonia
Objective:In this study,a prepared nanomaterial sensor was modified based on the chemical properties and material structure of the confirmed Stroke-associated pneumonia(SAP)biomarker to enable the detection of the SAP biomarker and to evaluate the differential diagnosis of SAP from non-SAP.Methods:The ischemic SAP model rats were established by photochemical method,and the hemorrhagic SAP model was established by collagenase injection method.Then the rats were placed in a fixed box,wiped the tail of the rats with alcohol,pressed 1/3 of the tail vein,injected Lipopolysaccharide after the blood was extracted from the syringe into the needle.LPS)solution(LPS dissolved in normal saline and administered at a dose of 10mg/kg)was used to establish a rat model of acute lung injury induced by endotoxin.Take a blood sample and place it in a test tube without anticoagulants;Natural agglutination at room temperature for 2-4h(anti-sun exposure),blood coagulation after the natural precipitation of the serum;Then fluorescence detection of the identified biomarkers was performed based on up-conversion nanomaterials.The Receiver Operating Characteristic Curve(ROC curve)was used to evaluate the differential diagnosis of SAP and non-SAP.Results:There were no statistical differences in Procalcitonin(PCT)and Uric acid(UA)levels between SAP and non-SAP rats,while C-reactive protein(CRP)levels in SAP group were significantly higher than those in non-SAP group.The difference was statistically significant(P<0.05).ROC curve was used to evaluate the value of main biomarker levels in differentiating SAP and non-SAP rats.The results showed that CRP level had high clinical value in differentiating SAP and non-SAP rats(P<0.05).Conclusion:There is a significant difference in CRP between SAP and non-SAP rats,but there is no significant difference in PCT and uric acid.CRP can be used as a reliable index to identify SAP and non-SAP rats.

Stroke-related pneumoniaBiomarkersC-reactive protein

林辛锋

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福建医科大学附属福州市第一医院呼吸与危重症医学科(福建福州 350122)

卒中相关肺炎 生物标志物 C-反应蛋白

福建省自然科学基金资助项目

2021J011305

2024

黑龙江医药
黑龙江省药品审评认证中心

黑龙江医药

影响因子:0.597
ISSN:1006-2882
年,卷(期):2024.37(4)
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