Changes and clinical significance of serum TLR4,sICAM-1 and urinary mALB in patients with glomerulonephritis and bacterial infection
Objective To explore and analyze the changes and clinical significance of serum Toll-like receptor 4(TLR4),soluble vascular intercellular adhesion molecule 1(sICAM-1)and urinary microalbuminuria(mALB)in patients with glomerulonephritis(RPGN)and bacterial infection.Methods A total of 107 patients with RPGN confirmed in the Zhengzhou Seventh People's Hospital were enrolled as RPGN group between May 2019 and May 2022.According to presence or absence of bacterial infection,they were divided into infection group(n=43)and non-infection group(n=64).A total of 107 healthy controls during the same period were randomly enrolled as control group.The characteristics of pathogens in infection group were statistically analyzed.The levels of serum TLR4,sICAM-1 and urinary mALB in all the objects were compared,and their diagnostic efficiency for bacterial infection was analyzed by receiver operating characteristic(ROC)curves.Results There were 49 strains of pathogens in infection group,including Gram-negative bacteria[59.18％,mainly Klebsiella pneumoniae(n=14)]and Gram-positive bacteria[40.82％,mainly Streptococcus hemolyticus(n=9)].The levels of serum TLR4,sICAM-1 and urinary mALB in RPGN group were(4.12±1.18)ng/mL,(283.65±37.36)ng/mL and(34.55± 3.18)mg/L,significantly higher than those in control group[(1.51±0.32)ng/mL,(104.39±23.27)ng/mL and[(21.36±2.47)mg/L],the differences were statistically significant(t=16.832,30.590,24.098;all P＜0.05).The levels of serum TLR4,sICAM-1 and urinary mALB in infection group[(5.29±1.69)ng/mL,(314.63±41.52)ng/mL and(38.74±3.26)mg/L]were significantly higher than non-infection group[(3.33±0.84)ng/mL,(263.10±34.57)ng/mL and(31.73±3.13)mg/L],the differences were statistically significant(t=7.944,6.968,11.170;all P＜0.05).Area under curve(AUC)values of serum TLR4,sICAM-1 and urinary mALB in the diagnosis of RPGN combined with bacterial infection were 0.698,0.648 and 0.689,respectively.The diagnostic efficiency of combined detection was higher(AUC=0.826,95％CI:0.746-0.905,P＜0.001).Conclusions The levels of serum TLR4,sICAM-1 and urinary mALB significantly increase in RPGN patients,especially in those with bacterial infection.Clinically,combined detection could improve diagnostic efficiency for RPGN combined with bacterial infection.
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